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髌神经切断术对单髁膝关节置换术后预后和跪姿能力的影响:一项随机临床试验。

The efficacy of patellar denervation on prognosis and kneeling capacity after unicompartmental knee arthroplasty: a randomized clinical trial.

机构信息

Department of Orthopedic Surgery, Affiliated Hospital of Xuzhou Medical University, 99 Huaihai Road, Xuzhou, Jiangsu, 221002, China.

出版信息

J Orthop Surg Res. 2024 Oct 5;19(1):626. doi: 10.1186/s13018-024-05015-0.

Abstract

OBJECTIVE

The aim of this study was to investigate the effect of patellar denervation (PD) on pain, function and ability to kneel after unicompartmental knee arthroplasty (UKA).

METHODS

Patients with medial knee osteoarthritis who underwent UKA were prospectively selected. Patients were randomly divided into PD and non-PD groups based on whether patellar denervation was performed. Clinical assessment was performed using the Hospital for Special Surgery (HSS) knee score, Kujiala score, visual analogue scale (VAS) and forgotten joint score (FJS-12), as well as postoperative complications were recorded. The patients' postoperative self-perception and actual ability to perform different kneeling positions were assessed in the two groups.

RESULTS

UKA patients treated with PD achieved better Kujiala scores and FJS-12 scores, reduced anterior knee pain and improved kneeling ability postoperatively, validating the effectiveness of PD in UKA. Perception and actual performance of kneeling remained mismatched in PD patients, but performance during different kneeling activities was generally better than in non-PD patients.

TRIAL REGISTRATION

Clinical Trial Registration: ChiCTR1900025669.

CONCLUSION

Patellar denervation can safely and effectively improve patellofemoral joint function, pain and kneeling ability in the early postoperative period after UKA.

摘要

目的

本研究旨在探讨髁上神经切断术(PD)对单髁膝关节置换术(UKA)后疼痛、功能和屈膝能力的影响。

方法

前瞻性选择内侧膝关节骨关节炎患者行 UKA。根据是否行髌上神经切断术将患者随机分为 PD 组和非 PD 组。采用美国特种外科医院(HSS)膝关节评分、Kujiala 评分、视觉模拟评分(VAS)和遗忘关节评分(FJS-12)进行临床评估,并记录术后并发症。评估两组患者术后对不同屈膝位的自我感知和实际能力。

结果

行 PD 的 UKA 患者术后 Kujiala 评分和 FJS-12 评分更高,前膝疼痛减轻,屈膝能力改善,证实 PD 在 UKA 中的有效性。PD 患者的屈膝感知和实际表现仍不匹配,但在不同的屈膝活动中,表现通常优于非 PD 患者。

试验注册

临床试验注册:ChiCTR1900025669。

结论

PD 可安全有效地改善 UKA 后早期髌股关节功能、疼痛和屈膝能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c424/11452953/d5d180e2b2fb/13018_2024_5015_Fig1_HTML.jpg

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