髌下脂肪垫保留与否对膝关节骨性关节炎病人关节置换术后疼痛程度、切口愈合及功能恢复的影响  

Effect of the preservation of infrapatellar fat pad on pain,incision healing and function recovery in patients with knee osteoarthritis after joint replacement

作　　者：赵阳 徐伟力 李行星 方栋 周亮 王启伟 窦强兵 ZHAO Yang;XU Weili;LI Xingxing;FANG Dong;ZHOU Liang;WANG Qiwei;DOU Qiangbing(Department of Orthopedics,Lu’an Hospital(Lu’an People’s Hospital),Anhui Medical University,Lu’an 237005,China)

机构地区：[1]安徽医科大学附属六安医院(六安市人民医院)骨科,237005

出　　处：《临床外科杂志》2025年第3期321-324,共4页Journal of Clinical Surgery

摘　　要：目的探讨髌下脂肪垫切除或保留对膝关节骨性关节炎病人关节置换术后疼痛程度、切口愈合及功能恢复的影响。方法2019年6月~2022年9月收治的膝关节骨性关节炎病人127例,根据术中是否保留髌下脂肪垫分为两组,对照组67例,切除髌下脂肪垫,观察组60例,保留髌下脂肪垫。比较术后12个月两组髌腱长度、疼痛、膝关节功能、活动度变化及不良反应发生状况。结果术后12个月,两组髌腱长度均降低,且观察组髌腱长度长于对照组[(38.8±6.24)mm比(36.2±6.71)mm],观察组髌腱长度变化率低于对照组[(4.1±1.18)%比(10.7±3.01)%],两组比较差异有统计学意义(P<0.05);较术前,两组术后1、3、6、12个月疼痛程度均减轻,观察组变化幅度大于对照组,差异有统计学意义(P<0.05);随访期间,观察组切口不良反应发生率为6.67%,低于对照组的14.93%,但差异无统计学意义(P>0.05);较术前,术后12个月两组膝关节活动度与功能均提升,但观察组提升幅度大于对照组,差异有统计学意义(P<0.05)。结论对行关节置换术的膝关节骨性关节炎病人予以保留髌下脂肪垫更有利于减轻术后疼痛程度,恢复膝关节功能,因此临床应尽量保留完整的髌下脂肪垫。Objective To explore the effect of the preservation of infrapatellar fat pad on pain,incision healing and function recovery in patients with knee osteoarthritis after joint replacement.Methods The clinical data of 127 patients with knee osteoarthritis who underwent joint replacement in the hospital from June 2019 to September 2022 were retrospectively collected.According to the preservation of infrapatellar fat pad,the subjects were divided into a control group(removing infrapatellar fat pad,67 cases)and an observation group(preserving infrapatellar fat pad,60 cases).The changes in length of patellar tendon,pain,knee function and range of motion were analyzed.The occurrence of adverse reactions was statistically analyzed.Results At 12 months after surgery,the length of patellar tendon was reduced.The length of patellar tendon in observation group[(38.8±6.24)mm]was longer than that in control group[(36.2±6.71)mm](P<0.05).Observation group of patellar tendon length rate is lower than the control group[(4.1±1.18)%vs(10.7±3.01)%],there was statistical significance between the two groups(P<0.05).Pain in both groups was alleviated at 1 month,3 months,6 months and 12 months after surgery.The changes in observation group were greater than those in control group(P<0.05).During follow-up,the incidence of adverse reactions in observation group(6.67%)was lower than that in control group(14.93%)(P>0.05).The range of motion and function of knee joint were improved at 12 months after surgery,and the improvement in observation group was greater than that in control group(P<0.05).Conclusion Preserving infrapatellar fat pad is more beneficial to relieving postoperative pain and restoring knee function in patients with knee osteoarthritis after joint replacement.Therefore,the intact infrapatellar fat pad should be preserved as possible in clinical practice.

关 键 词：髌下脂肪垫 膝关节骨性关节炎 关节置换术 疼痛程度 切口愈合 功能恢复 

分 类 号：R68[医药卫生—骨科学]