本文選題：膝關(guān)節(jié)置換 + 膝前痛��； 參考：《山東醫(yī)藥》2017年48期

【摘要】：目的探討髕骨周圍電灼去神經(jīng)化對全膝關(guān)節(jié)置換術(shù)(TKA)后患者膝前痛及膝關(guān)節(jié)功能的影響。方法選取行單側(cè)TKA治療的重度膝骨關(guān)節(jié)炎患者64例(64膝),隨機(jī)分為去神經(jīng)組和未去神經(jīng)組,每組32例(32膝)。兩組術(shù)中均不行髕骨置換。去神經(jīng)組術(shù)中行髕骨周圍電灼去神經(jīng)化處理。統(tǒng)計(jì)手術(shù)時(shí)間,計(jì)算累積總引流量;術(shù)前、術(shù)后6周和術(shù)后3、6、12個(gè)月時(shí)分別進(jìn)行美國膝關(guān)節(jié)外科協(xié)會(KSS)膝和膝功能評分、Feller髕骨和功能評分、膝關(guān)節(jié)活動度(ROM)檢測及疼痛視覺模擬(VAS)評分。結(jié)果兩組手術(shù)均成功,兩組手術(shù)時(shí)間及累積總引流量比較P均0.05。兩組術(shù)后6周和術(shù)后3、6、12個(gè)月時(shí)KSS膝及膝功能評分、Feller髕骨及髕骨功能評分、ROM均高于術(shù)前,VAS評分均低于術(shù)前;去神經(jīng)組術(shù)后3、6、12個(gè)月時(shí)KSS膝及膝功能評分、VAS評分均高于未去神經(jīng)組,ROM低于未去神經(jīng)組;去神經(jīng)組術(shù)后6、12個(gè)月時(shí)Feller髕骨評分均高于未去神經(jīng)組;組間及組內(nèi)比較P均0.05。術(shù)后12個(gè)月時(shí),去神經(jīng)組膝關(guān)節(jié)功能優(yōu)良率高于未去神經(jīng)組(P0.05);膝前痛發(fā)生率低于未去神經(jīng)組(P0.05)。結(jié)論髕骨周圍電灼去神經(jīng)化處理可降低TKA后膝前痛程度及發(fā)生率,并促進(jìn)膝關(guān)節(jié)功能恢復(fù)。
[Abstract]:Objective to investigate the effect of peripatellar electrocautery on anterior knee pain and knee function after total knee arthroplasty (TKA). Methods 64 patients with severe knee osteoarthritis treated with unilateral TKA were randomly divided into denervated group (n = 32) and non-denervated group (n = 32). Patella replacement was not performed in both groups. In the denervated group, peripatellar electrocautery was performed. Before operation, 6 weeks after operation, 6 weeks after operation, 6 months after operation and 12 months after operation, the knee and knee function score (Feller patella and function score) of the American Association of knee Surgeons (AKS) were evaluated, respectively. Knee motion was measured and visual analogue pain was assessed. Results the operation time and cumulative total drainage in both groups were all successful (P 0.05). KSS knee and knee function scores in both groups were higher than those before operation at 6 weeks after operation and 6 months after operation, and at 12 months, the scores of Feller patella and patella function were lower than those before operation. In the denervated group, the KSS knee and knee function scores were significantly higher than those in the non-denervated group at 3 and 12 months after operation, and the Feller patella score in the denervated group was higher than that in the non-denervated group at 6 and 12 months after operation (P < 0.05). At 12 months after operation, the excellent and good rate of knee joint function in the denervated group was higher than that in the non-denervated group, and the incidence of anterior knee pain was lower than that in the non-denervated group. Conclusion Peripatellar electrocauterization can reduce the degree and incidence of anterior knee pain after TKA and promote the recovery of knee function.
【作者單位】： 天津醫(yī)科大學(xué)第四中心臨床學(xué)院;武警后勤學(xué)院附屬醫(yī)院骨科醫(yī)院;
【基金】：天津市衛(wèi)生行業(yè)重點(diǎn)攻關(guān)項(xiàng)目(15kg122)
【分類號】：R687.4

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