单髁置换术中髌骨去神经化对术后早期膝前疼痛与膝关节功能的影响  

Effect of Patellar Denervation on Early Postoperative Anterior Knee Pain and Knee Function in Unicompartmental Knee Arthroplasty

作　　者：吕欣[1] 苏日娜[2] 孙智文[1] 张一波 陈晓伟 郑宏梅 Lyu Xin;Su Rina;Sun Zhiwen;Zhang Yibo;Chen Xiaowei;Zheng Hongmei(Department of Orthopaedics,Chifeng Municipal Hospital,Chifeng 024000,China;Department of Anesthesiology,Chifeng Municipal Hospital,Chifeng024000,China)

机构地区：[1]赤峰市医院骨关节科,内蒙古赤峰024000 [2]赤峰市医院麻醉科,内蒙古赤峰024000

出　　处：《实用骨科杂志》2022年第10期903-906,915,共5页Journal of Practical Orthopaedics

基　　金：内蒙古自治区自然科学基金项目(2020MS08144);内蒙古自治区赤峰市自然科学科研立项课题(SZR2022195);实用新型专利:一种膝关节单髁置换手术工具(ZL202021670800.1)。

摘　　要：目的分析单髁置换术(unicompartmental knee arthroplasty,UKA)中髌骨去神经化处理对术后早期膝前疼痛与膝关节功能的影响。方法回顾性分析赤峰市医院骨关节科2018年12月至2020年4月收治的80例膝关节骨关节炎(knee osteoarthritis,KOA)患者,全部患者均行UKA治疗,将其中术中行髌骨周围去神经化处理的40例患者纳入观察组,选取同期术中未行髌骨周围去神经化处理的40例患者纳入对照组。观察组:男10例,女30例;年龄46~77岁,平均(62.13±7.78)岁;右膝20例,左膝20例。对照组:男8例,女32例;年龄47~76岁,平均(62.23±7.14)岁;右膝19例,左膝21例。于术后3、6、12、24个月行门诊随访观察,以末次随访为准,记录患者的Feller髌骨评分、美国特种外科医院(hospital for special surgery,HSS)评分、西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎指数及膝前疼痛的发生率,通过所得数据分析UKA中髌骨周围去神经化对术后早期膝前疼痛与膝关节功能的影响。结果所有患者均获随访,随访至术后24个月。末次随访时观察组Feller髌骨评分较对照组有明显提高,差异有统计学意义(P<0.05);两组HSS评分、WOMAC评分比较差异无统计学意义(P>0.05);观察组术后膝前疼痛发生率为10.0%(4/40),对照组术后膝前疼痛发生率为27.5%(11/40),差异有统计学意义(P<0.05)。结论UKA中行髌骨周围去神经化处理在术后早期可以有效降低膝前疼痛的发生率,提高股四头肌肌力,改善膝关节功能。Objective To analyze the effect of patellar denervation in unicompartmental knee arthroplasty(UKA)on early postoperative anterior knee pain and knee function.Methods A retrospective study was conducted to analyze 80 patients with knee osteoarthritis(KOA)admitted to the Department of Osteoarthritis of Chifeng Municipal Hospital from December 2018 to April 2020.Forty patients with peripheral denervation treatment were included in the observation group,and 40 patients without peripheral denervation treatment of the patella during the same period were selected and included in the control group.Observation group included 10 males and 30 females average age was(62.13±7.78)years(range,46~77 years).The 20 cases of right knee and 20 cases of left knee.Control group had 8 males and 32 females.The average age was(62.23±7.14)years(range,47~76 years).There were 19 cases of right knee and 21 cases of left knee.Outpatient follow-up was performed at 3 months,6 months,12 months,and 24 months after operation.The last follow-up was used as the criterion.The Feller patella score,hospital for special surgery(HSS)knee score,the Western Ontario and McMaster Universities(WOMAC)osteoarthritis index and the incidence of anterior knee pain were collected.The resulting data analyzed the effect of peripatellar denervation in UKA on early postoperative anterior knee pain and knee function.Results All patients in this study were followed up until 24 months after operation.At the last follow-up,the Feller patella score in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the scores,and the difference was not statistically significant(P>0.05).The incidence of postoperative knee pain in the observation group was 10.0%(4/40),which was lower than that in the control group,27.5%(11/40),and the difference was statistically significant(P<0.05).Conclusion Denervation around the patella in UKA can effectively reduce the incidence

关 键 词：膝 骨关节炎 单髁置换 髌骨周围去神经化 膝前痛 

分 类 号：R687.4[医药卫生—骨科学]