全膝关节置换术中髌骨成形术联合髌骨钻孔减压的临床研究  

Clinical Study of Patelloplasty Combined Patellar Decompression Via Drilling in Total Knee Arthroplasty

作　　者：石训达 史晨辉[2] SHI Xun-da;SHI Chen-hui(Shihezi Univerisity School of Medicine,Xinjiang Shihezi,832002;Department of Orthopedic Center,The First Affiliated Hospital of Shihezi University,Xinjiang Shihezi,832008)

机构地区：[1]石河子大学医学院,新疆石河子832002 [2]石河子大学第一附属医院骨科中心,新疆石河子832008

出　　处：《农垦医学》2023年第5期421-426,共6页Journal of Nongken Medicine

基　　金：国家自然科学基金项目(81772407)。

摘　　要：目的:探究全膝关节置换术中髌骨成形术联合髌骨钻孔减压的临床疗效。方法:选取2021年01月至2021年10月期间符合纳排标准的96例膝骨关节炎行全膝关节置换手术患者,随机分为两组,髌骨减压组45例患者,采用髌骨钻孔减压术联合髌骨成形术处理髌骨;髌骨成形组51例患者,仅采用髌骨成形术处理髌骨。观察两组患者术后相关并发症、手术切口愈合情况、比较术后1、3、6及12个月的髌骨评分(Feller Score)、美国膝关节外科协会评分(Knee Surgery Society,KSS)、视觉模拟评分(visual analogue scale,VAS)及术后膝前疼发生率等。结果:两组患者均无严重术后相关并发症发生,手术切口均一期愈合,96例手术患者均完整随访12个月。术后6个月、12个月的Feller髌骨评分,VAS评分,KSS膝评分及术后3个月、6个月、12个月的KSS功能评分髌骨减压组优于髌骨成形组,差异有统计学意义(P<0.05);术后12个月随访膝前疼发生率髌骨减压组为11.11%(5/45),髌骨成形组为29.41%(15/51),两组比较差异有统计学意义(χ^(2)=4.854,P=0.028)。结论:TKA术中采用髌骨钻孔减压可在一定程度上改善膝关节KSS评分、VAS评分及Feller髌骨评分,降低术后膝前疼发生率。Objective:To investigate the clinical efficacy of combined patellar decompression via drilling in total knee arthroplasty(TKA).Methods:96 patients with knee osteoarthritis undergoing TKA between January 2021 and October 2021 who met the inclusion and exclusion criteria were selected and randomly divided into two groups.45 patients in the patellar decompression group,the patella was treated with patellar decompression via drilling combined with patelloplasty;51 patients in the patelloplasty group,the patella was treated with patelloplasty only.Postoperative complications,surgical incision healing,Feller score,Knee Surgery Society score(KSS),visual analogue scale(VAS)and incidence of postoperative anterior knee pain were observed in both groups at 1st,3rd,6th and 12th months after surgery.Results:The two groups of patients got postoperative wound healing of stage I.No serious complications were found.All patients got complete follow-up for 12 months.The results in Feller patella score,KSS knee score and VAS score were statistically higher in the patellar decompression group than the patelloplasty group at the time of 6 months and 12 months after the operations.The results in KSS function score were statistically higher in the patellar decompression group than the patelloplasty group at the time of 3 months,6 months,and 12 months after the operations,and the difference was statistically significant(P<0.05).The postoperative incidence of anterior knee pain was found to be 29.41%(15/51)and 11.11%(5/45),respectively.They were significantly different from one another(X^(2)=4.854,=0.028).Conclusions:The TKA with patellar decompression via drilling can result in higher KSS knee and function score,VAS score,and Feller patella score and lower incidence of anterior knee pain.

关 键 词：膝关节骨关节炎 全膝关节置换 髌骨钻孔减压 

分 类 号：R687.4[医药卫生—骨科学]