【摘要】：目的:探討髕骨軟骨退變程度與膝骨關(guān)節(jié)炎TKA術(shù)后AKP的相關(guān)性,分析TKA術(shù)后出現(xiàn)AKP的原因。方法:收集2015年12月至2017年2月期間在我院骨關(guān)節(jié)外科因膝骨關(guān)節(jié)炎行全膝關(guān)節(jié)置換術(shù)的83例(102膝)患者病例資料。其中男12例(14膝),女性71例(88膝),年齡(65.8±7.6)歲。術(shù)中觀察髕骨軟骨退變位置,并采用Outerbridge分級標(biāo)準(zhǔn)評定髕骨軟骨退變等級。將髕骨軟骨整體退變IV級的患者歸為A1組,將I~III級患者歸為B1組;然后將髕骨軟骨外側(cè)面退變達(dá)到IV級患者歸為A2組,I~III級患者歸為B2組。術(shù)前及術(shù)后第1、3、6、12個月進(jìn)行VAS評分并明確疼痛部位,術(shù)前及末次隨訪時進(jìn)行KSS評分和Feller髕股關(guān)節(jié)評分。結(jié)果:全部病例得到隨訪,隨訪2~17個月,平均隨訪8.5個月。髕骨軟骨整體退變等級:I級12膝,Ⅱ級11膝,Ⅲ級18膝,Ⅳ級61膝。髕骨軟骨外側(cè)面Ⅳ級共36膝,I~III級共66膝。A1、B1兩組術(shù)后6個月和12個月膝前痛發(fā)生率、術(shù)前及術(shù)后KSS臨床評分、KSS功能評分、Feller評分、VAS評分均無明顯差異(P0.05)。A2、B2兩組術(shù)后12個月膝前痛發(fā)生率差異有統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后6個月膝前痛發(fā)生率、術(shù)前及術(shù)后KSS臨床評分、KSS功能評分、Feller評分、VAS評分均無明顯差異(P0.05)�；颊咝g(shù)后VAS評分、KSS臨床評分、KSS臨床評分、Feller評分均較術(shù)前改善,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)論:(1)無論髕骨軟骨整體退變是否到達(dá)IV級,TKA術(shù)后膝前痛的發(fā)生率及膝關(guān)節(jié)功能無明顯差異,不建議將髕骨軟骨整體退變達(dá)到IV級作為髕骨置換的指標(biāo);(2)髕骨軟骨外側(cè)面退變達(dá)到IV級患者TKA術(shù)后12個月膝前痛發(fā)生率較高;(3)膝骨關(guān)節(jié)炎患者行保留髕骨型全膝關(guān)節(jié)置換術(shù),術(shù)后功能評分和疼痛評分均較術(shù)前明顯改善,短期療效滿意。
[Abstract]:Objective: to investigate the correlation between the degree of degeneration of patellar cartilage and AKP after TKA in knee osteoarthritis, and to analyze the causes of AKP after TKA. Methods: from December 2015 to February 2017, 83 patients (102 knees) with osteoarthritis underwent total knee arthroplasty in our hospital. There were 12 males (14 knees) and 71 females (88 knees) aged (65.8 鹵7.6) years. The degenerative position of patellar cartilage was observed during operation and the grade of degeneration of patellar cartilage was evaluated by Outerbridge grading standard. The patients with global degeneration of patellar cartilage in IV grade were classified into A1 group, I~III grade group was classified into B1 group, and the patients with lateral degeneration of patellar cartilage to IV grade were classified as A2 group and B2 group. VAS score and pain location were evaluated at 12 months and KSS score and Feller patellofemoral joint score were performed before and at the last follow-up. Results: all the patients were followed up for 2 ~ 17 months with an average of 8.5 months. The total degeneration grade of patella cartilage was 12 knees in grade I, 11 knees in grade 鈪，

本文編號：2211173