Keblish P A, Varma A K, Greenwald A S
Department of Surgery, Lehigh Valley Hospital, Allentown, Pennsylvania 18105-1556.
J Bone Joint Surg Br. 1994 Nov;76(6):930-7.
Patellofemoral problems are a common cause of morbidity and reoperation after total knee arthroplasty. We made a prospective study of 52 patients who had bilateral arthroplasty (104 knees) and in whom the patella was resurfaced on one side and not on the other. A movable-bearing prosthesis with an anatomical femoral groove was implanted on both sides by the same surgeon using an otherwise identical technique. The mean follow-up was 5.24 years (2 to 10). In the 30 available patients (60 knees) there was no difference between the two sides in subjective preference, performance on ascending and descending stairs or the incidence of anterior knee pain. Radiographs showed no differences in prosthetic alignment, femoral condylar height, patellar congruency or joint line position. The use of an appropriate prosthetic design and careful surgical technique can provide equivalent results after knee arthroplasty with or without patellar resurfacing. Given the indications and criteria, which we discuss, retention of the patellar surface is an acceptable option.
髌股关节问题是全膝关节置换术后发病和再次手术的常见原因。我们对52例接受双侧关节置换术（104个膝关节）的患者进行了前瞻性研究，这些患者一侧髌骨进行了表面置换，另一侧未进行。同一位外科医生使用相同的技术在两侧植入了带有解剖型股骨凹槽的活动平台假体。平均随访时间为5.24年（2至10年）。在30例可获得随访的患者（60个膝关节）中，两侧在主观偏好、上下楼梯表现或膝前疼痛发生率方面没有差异。X线片显示假体对线、股骨髁高度、髌骨匹配度或关节线位置没有差异。采用合适的假体设计和精细的手术技术，无论是否进行髌骨表面置换，膝关节置换术后都能取得相似的效果。根据我们讨论的适应症和标准，保留髌骨表面是一个可接受的选择。
