[1]理阳,柴昊,孙永强,等.髌骨置换与髌骨成形对膝骨关节炎膝外翻畸形全膝关节置换术后近期疗效的影响[J].中医正骨,2025,37(12):8-13,20.
　LI Yang,CHAI Hao,SUN Yongqiang,et al.Effects of patellar resurfacing versus patelloplasty on short-term outcomes of total knee arthroplasty in knee osteoarthritis with valgus deformity: a clinical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2025,37(12):8-13,20.
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髌骨置换与髌骨成形对膝骨关节炎膝外翻畸形全膝关节置换术后近期疗效的影响()

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期数:
2025年12期
页码:
8-13,20
栏目:
临床研究
出版日期:
2025-12-20

文章信息/Info

Title:
Effects of patellar resurfacing versus patelloplasty on short-term outcomes of total knee arthroplasty in knee osteoarthritis with valgus deformity: a clinical study
作者:
理阳; 柴昊; 孙永强; 李帅垒
(河南省洛阳正骨医院/河南省骨科医院,河南 郑州 450016)
Author(s):
LI Yang; CHAI Hao; SUN Yongqiang; LI Shuailei
Luoyang Orthopedic-Traumatological Hospital,Zhengzhou 450016,Henan,China
关键词:
膝外翻;  骨关节炎; 膝;  关节成形术; 置换; 膝;  髌骨;  非随机对照试验专题
Keywords:
genu valgum;  osteoarthritis; knee;  arthroplasty; replacement; knee;  patella;  non-randomized controlled trials as topic
摘要:
目的:探讨髌骨置换与髌骨成形对膝骨关节炎(knee osteoarthritis,KOA)膝外翻畸形全膝关节置换术(total knee arthroplasty,TKA)后近期疗效的影响。方法:回顾性分析2021年9月至2024年4月采用TKA治疗的KOA膝外翻畸形患者的病例资料,术中行髌骨置换者纳入髌骨置换组,行髌骨成形者纳入髌骨成形组。比较2组患者的术中出血量、术后引流量、手术时间,术后6个月的关节遗忘评分(forgotten joint score,FJS)、髌骨倾斜度,术前与术后6个月的美国膝关节协会评分(knee society score,KSS)、Feller髌骨评分、膝关节疼痛视觉模拟量表(visual analogue scale,VAS)评分,其中KSS包括临床与功能评分。结果:共纳入49例患者,其中髌骨置换组23例、髌骨成形组26例。2组患者术中出血量、术后引流量的组间差异均无统计学意义(t=0.732,P=0.468; t=0.718,P=0.476); 与髌骨成形组相比,髌骨置换组的手术时间长,术后6个月的FJS高、髌骨倾斜度小(t=6.458,P=0.001; t=6.442,P=0.001; t=-15.880,P=0.001)。术后6个月,2组患者的KSS临床与功能评分、Feller髌骨评分均较术前提高(KSS临床评分:t=29.439,P=0.000; t=19.440,P=0.000; KSS功能评分:t=29.993,P=0.000; t=20.513,P=0.000; Feller髌骨评分:t=25.555,P=0.000; t=14.973,P=0.000),且髌骨置换组的评分均高于髌骨成形组(t=11.019,P=0.001; t=9.068,P=0.001; t=8.795,P=0.001)。术后6个月,2组患者的膝关节疼痛VAS评分均较术前降低(t=-23.459,P=0.000; t=-15.509,P=0.000),且髌骨置换组的评分低于髌骨成形组(t=-3.709,P=0.001)。结论:对于接受TKA的KOA膝外翻畸形患者,相较于髌骨成形,髌骨置换在促进膝关节功能恢复、提高髌骨稳定性和减轻膝关节疼痛方面的短期疗效更好,但两种术式造成的组织损伤程度相当,且髌骨置换会延长手术时间。
Abstract:
Objective:To investigate the effects of patellar resurfacing versus patelloplasty on the short-term outcomes of total knee arthroplasty(TKA)in patients with knee osteoarthritis(KOA)and valgus deformity.Methods:The clinical data of patients who underwent TKA for KOA and valgus deformity from September 2021 to April 2024 were retrospectively analyzed.The patients were allocated into patellar resurfacing group and patelloplasty group based on the intraoperative procedure performed.The intraoperative blood loss,postoperative drainage volume,operative time,the forgotten joint score(FJS)and patellar tilt angle measured at 6-month post-procedure,as well as the knee society score(KSS,including clinical and functional subscores),Feller patellar score,and knee pain visual analogue scale(VAS)score assessed before the procedure and at 6-month post-procedure,were compared between the 2 groups.Results:Forty-nine patients were enrolled in the study,23 ones in patellar resurfacing group and 26 ones in patelloplasty group.The intraoperative blood loss and postoperative drainage volume were not significantly different between the 2 groups(t=0.732,P=0.468; t=0.718,P=0.476),while,the operative time was longer,the FJS measured at 6-month post-procedure was higher,and the patellar tilt angle measured at 6-month post-procedure was smaller in patellar resurfacing group compared to patelloplasty group(t=6.458,P=0.001; t=6.442,P=0.001; t=-15.880,P=0.001).At 6-month post-procedure,the KSS clinical and functional subscores,as well as the Feller patellar score,increased in both groups compared to the preoperative values(KSS clinical subscore:t=29.439,P=0.000; t=19.440,P=0.000; KSS functional subscore:t=29.993,P=0.000; t=20.513,P=0.000; Feller patellar score:t=25.555,P=0.000; t=14.973,P=0.000),with higher values observed in patellar resurfacing group compared to patelloplasty group(t=11.019,P=0.001; t=9.068,P=0.001; t=8.795,P=0.001).In addition,the knee pain VAS score decreased in both groups compared to the preoperative value at 6-month post-procedure(t=-23.459,P=0.000; t=-15.509,P=0.000),with lower value observed in patellar resurfacing group compared to patelloplasty group(t=-3.709,P=0.001).Conclusion:The patellar resurfacing demonstrates superior short-term outcomes in promoting knee functional recovery,enhancing patellar stability,and alleviating knee pain compared to patelloplasty in patients undergoing TKA for KOA and valgus deformity.However,the both are comparable in tissue damage degree,and the former increases the operative time.

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备注/Memo

备注/Memo:
通讯作者:李帅垒 E-mail:joint999@126.com
(收稿日期:2025-07-15 本文编辑:郭毅曼)
更新日期/Last Update: 2025-12-20