全膝关节置换术中髌骨翻转对术后早期膝关节功能的影响  

Effect of patellar eversion in total knee arthroplasty on postoperative early knee function

作　　者：昝鹏飞[1] 杨勇[1] 李国东[1] 茅凌洲[1] 蔡郑东[1] 蔡新宇[1] 

机构地区：[1]同济大学附属第十人民医院骨科,上海200072

出　　处：《国际骨科学杂志》2015年第1期66-69,共4页International Journal of Orthopaedics

摘　　要：目的评价全膝关节置换术(TKA)中髌骨翻转对术后早期膝关节功能的影响。方法纳入2008年4月至2013年9月32例双侧同期TKA患者,随机分为髌骨翻转组(A组)与髌骨侧方移位组(B组)。比较分析双膝手术时间、术后并发症、实现主动直腿抬高时间和膝关节90°屈曲时间及术后7 d、3个月、6个月、1年膝关节主动活动度、膝关节被动活动度、疼痛视觉模拟评分(VAS)。结果 A组与B组实现主动直腿抬高的时间分别为(2.6±0.8)d和(2.1±0.6)d(P=0.043)。除术后6个月两组膝关节被动活动度无统计学差异外,其余各随访时间点A组膝关节主动活动度、被动活动度均较B组差。两组手术时间、术后并发症、实现膝关节90°屈曲时间及VAS评分均无统计学差异。结论 TKA中髌骨翻转不利于术后早期膝关节功能康复,可延缓患者实现直腿抬高时间,减少术后膝关节活动度。Objective To assess the effect of patellar eversion in total knee arthroplasty（TKA）on the postoperative early knee function.Methods We prospectively enrolled 32 patients whose knees were treated of TKA simultaneously from April 2008 to September 2013,one knee was operated with patellar eversion（group A）and the other was operated with patellar lateral retraction（group B）randomly.The operation time,complications,the time of achieving strait leg raise（SLR）and 90°knee flexion were evaluated.Range of motion（ROM）and visual analogue scale（VAS）score were evaluated separately at seven days,three months,six months and one year postoperatively.Results The time of achieving SLR was 2.6±0.8 d in group A and 2.1±0.6 d in group B（P=0.043）.Significant difference was found between group A and group B on active and positive ROM during the follow-up time,except the positive ROM at 6 month postoperatively.No significant difference was found on operation time,complications,the time of achieving90°knee flexion and VAS score during the follow-up time.Conclusion Patellar eversion in TKA was adverse to the early knee function recovery,it will delay the time of achieving SLR,decreased the positive and active ROM.

关 键 词：全膝关节置换 髌骨 翻转 侧方移位 

分 类 号：R687.4[医药卫生—骨科学]