Kunugiza Yasuo, Tsuji Shigeyoshi, Fujito Toshitaka, Tamaki Masashi, Nishikawa Masataka, Nomura Koji, Ishibashi Teruya, Tomita Tetsuya
Department of Orthopaedic Surgery, Japan Community Health Care Organization (JCHO) Hoshigaoka Medical Center, Hoshigaoka 4-8-1, Hirakata City, Osaka, 573-8511, Japan.
Department of Orthopaedics, Rehabilitation, Rheumatology & Psoriasis Center Nippon Life Hospital, Enokojima 2-1-54, Osaka City Nishiku, Osaka, 550-0006, Japan.
J Orthop. 2024 Oct 29;62:133-138. doi: 10.1016/j.jor.2024.10.038. eCollection 2025 Apr.
Several patients experience chronic pain after total knee arthroplasty (TKA), with the source of postoperative pain attributed to intra- and extra-articular factors. This study focused on the proximal tibia with either the Pes anserinus (PA) or around Gerdy's tubercle (GT) as the most common site of extra-articular pain.
This prospective study included 270 patients (360 knees) with advanced varus osteoarthritis (OA) of the knee scheduled for primary TKA and the patient population comprised 289 women and 71 men with a mean age of 74.7 ± 7.4 years. Operative procedure was performed by a single surgeon. This study investigated the prevalence of PA and GT tenderness over the knee before and after TKA and the association between this tenderness and several factors.
Before TKA, 66.1 % of the patients experienced PA tenderness, whereas 33.1 % experienced GT tenderness. One year after TKA, 49.7 % of the patients experienced PA tenderness, whereas 19.7 % experienced GT tenderness. More than half of the postoperative symptoms in the extra-articular region remained from the preoperative period. Female sex and high body mass index were associated with preoperative and postoperative tenderness of the PA and postoperative tenderness of GT. Postoperative PA and GT tenderness is associated with lower Knee Scoring System 2011 subjective and functional activity scores.
The extra-articular region (PA or GT) is associated with postoperative joint pain and function after knee arthroplasty, and more than half of the postoperative symptoms in the extra-articular region remained from the preoperative period.
部分患者在全膝关节置换术（TKA）后会经历慢性疼痛，术后疼痛的来源归因于关节内和关节外因素。本研究聚焦于胫骨近端，以鹅足（PA）或Gerdy结节（GT）周围作为关节外疼痛最常见的部位。
这项前瞻性研究纳入了270例（360膝）计划进行初次TKA的晚期膝关节内翻骨关节炎（OA）患者，患者群体包括289名女性和71名男性，平均年龄为74.7±7.4岁。手术由一名外科医生进行。本研究调查了TKA前后膝关节PA和GT压痛的患病率以及这种压痛与多种因素之间的关联。
TKA前，66.1%的患者有PA压痛，而33.1%的患者有GT压痛。TKA后一年，49.7%的患者有PA压痛，而19.7%的患者有GT压痛。关节外区域超过一半的术后症状与术前相同。女性和高体重指数与PA术前和术后压痛以及GT术后压痛相关。术后PA和GT压痛与较低的2011年膝关节评分系统主观和功能活动评分相关。
关节外区域（PA或GT）与膝关节置换术后的关节疼痛和功能相关，且关节外区域超过一半的术后症状与术前相同。
