本文選題：膝關節(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化對全膝關節(jié)置換術(TKA)后患者膝前痛及膝關節(jié)功能的影響。方法選取行單側TKA治療的重度膝骨關節(jié)炎患者64例(64膝),隨機分為去神經組和未去神經組,每組32例(32膝)。兩組術中均不行髕骨置換。去神經組術中行髕骨周圍電灼去神經化處理。統(tǒng)計手術時間,計算累積總引流量;術前、術后6周和術后3、6、12個月時分別進行美國膝關節(jié)外科協(xié)會(KSS)膝和膝功能評分、Feller髕骨和功能評分、膝關節(jié)活動度(ROM)檢測及疼痛視覺模擬(VAS)評分。結果兩組手術均成功,兩組手術時間及累積總引流量比較P均0.05。兩組術后6周和術后3、6、12個月時KSS膝及膝功能評分、Feller髕骨及髕骨功能評分、ROM均高于術前,VAS評分均低于術前;去神經組術后3、6、12個月時KSS膝及膝功能評分、VAS評分均高于未去神經組,ROM低于未去神經組;去神經組術后6、12個月時Feller髕骨評分均高于未去神經組;組間及組內比較P均0.05。術后12個月時,去神經組膝關節(jié)功能優(yōu)良率高于未去神經組(P0.05);膝前痛發(fā)生率低于未去神經組(P0.05)。結論髕骨周圍電灼去神經化處理可降低TKA后膝前痛程度及發(fā)生率,并促進膝關節(jié)功能恢復。
[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)科大學第四中心臨床學院;武警后勤學院附屬醫(yī)院骨科醫(yī)院;
【基金】：天津市衛(wèi)生行業(yè)重點攻關項目(15kg122)
【分類號】：R687.4

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