单髁置换术中髌骨不同处理方式疗效评价  

Efficacy evaluation of different treatments of patella in unicompartmental knee arthroplasty

作　　者：张昆[1] 关振鹏 刘家帮[1] 张清华[1] 裴征 李冬[1] 薛涛[1] Zhang Kun;Guan Zhenpeng;Liu Jiabang;Zhang Qinghua;Pei Zheng;Li Dong;Xue Tao(Department of Orthopedics,Peking University Shougang Hospital,Beijing 100144,China)

机构地区：[1]北京大学首钢医院骨科,100144

出　　处：《北京医学》2020年第4期275-278,共4页Beijing Medical Journal

摘　　要：目的观察髌骨不同处理方式在膝关节前内侧骨关节炎单髁置换术(unicompartmental knee arthroplasty,UKA)后的临床疗效。方法选取2016年1月至2019年1月北京大学首钢医院行UKA的患者59例,其中A组(UKA组)43例,B组(UKA+髌骨成形术组)16例,随访时间8~37个月,平均19.6个月,评价两组在住院时间、手术时间、术中出血量、下地负重时间等方面的差异,观测术前术后髌骨外倾角的变化,采用美国特种外科医院膝关节评分(American hospital for special surgery knee score,HSS)评价膝关节功能,英国骨关节协会满意度评分行患者满意度调查。结果两组在住院时间、术中出血量、下地负重时间方面比较差异无统计学意义(P>0.05),末次随访时两组患者满意度方面差异无统计学意义(P>0.05);A组术前术后髌骨外倾角为(4.55±1.16)°和(4.04±0.98)°,B组由术前(8.21±1.58)°降至(4.51±0.97)°,两组术前术后髌骨外倾角变化差异有统计学意义(P<0.01),但末次随访两组髌骨外倾角变化差异无统计学意义(P>0.05)。结论髌骨成形术组和髌骨未处理组均有创伤小、功能恢复快、患者满意度高的优点,对退变较重的髌股关节行髌骨成形术临床效果满意,膝关节近期功能恢复良好,中远期疗效有待观察。Objective To explore the clinical effect of different treatments of patella in unicompartmental knee arthroplasty(UKA)in the treatment of anteromedial osteoarthritis of knee joint.Methods Retrospective analysis of 59 elderly patients who were followed up from Department of Orthopaedics,Shougang Hospital of Peking University from January 2016 to January 2019.There were 43 cases in group A(UKA group)and 16 cases in group B(UKA and patellar resurfacing group).The average follow-up time was 19.6 months(8-37 months).The hospital stay,operation time,intraoperative blood loss and partial loading time were evaluated between the two groups.The changes of patella tilting angle before and after surgery were observed.Knee function was evaluated by American hospital for special surgery knee score(HSS),and patients’satisfaction degree was evaluated by the British Osteoarthritis Association Satisfaction Scale.Results There were no significant difference in hospital stay,intraoperative blood loss and partial loading time between the two groups(P>0.05).There was no significant difference in the average satisfactions between the two groups at the last follow-up(P>0.05).The patella tilting angle was(4.55±1.16)°and(4.04±0.98)°before and after operation in group A,(8.21±1.58)°and(4.51±0.97)°in group B.There was significant difference in patella tilting angle of each group respectively before and after operation(P<0.05).But there was no significant difference between the two groups at the last follow-up(P>0.05).Conclusions Both groups have the advantage of small trauma,quicker recovery of function and high levels of satisfaction.The results of patellar resurfacing for the degenerative heavy patellofemoral joint are satisfactory in the UKA.The short-term function of knee joint recovers well,but the medium and long-term effect remain to be observed.

关 键 词：膝关节前内侧骨关节炎 单髁置换术 髌骨成形术 

分 类 号：R687.4[医药卫生—骨科学]