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单侧全膝关节置换术中髌骨缩小联合外侧支持带松解在退行性膝骨关节炎患者中的应用

【来源:《华夏医学》编辑部 | 作者:《华夏医学》编辑部 | 编辑:李佳睿 | 发布日期:2022-08-04】

单侧全膝关节置换术中髌骨缩小联合外侧支持带松解在退行性膝骨关节炎患者中的应用

陈长生

(洛阳新区人民医院骨科,河南 洛阳 471000)


摘要 目的:探讨单侧全膝关节置换术中髌骨缩小联合外侧支持带松解在退行性膝骨关节炎患者中的应用。 方法:对 98 例退行性膝骨关节炎患者的临床资料进行回顾性分析,按照手术方法不同分为A 组(n=45)和 B 组(n=53)。 A 组在单侧全膝关节置换术中行髌骨缩小联合外侧支持带松解,B 组在术中行髌骨缩小。 比较两组膝前痛及髌骨轨迹不良发生情况、手术前后膝功能、髌骨功能、并发症发生率。 结果:A 组膝前痛发生率 6.67%低于 B 组 22.64%(P<0.05);术后 1 年,A 组膝关节协会评分(KSS)、髌骨评分(Feller)高于 B 组(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:单侧全膝关节置换术中髌骨缩小联合外侧支持带松解可以减少退行性膝骨关节炎患者膝前痛的发生,改善膝关节功能及髌骨功能,安全性较好。

关键词: 全膝关节置换术;髌骨缩小;外侧支持带松解;退行性膝骨关节炎

中图分类号:R687.4 文献标志码:A 文章编号:1008-2409(2022)03-0065-04

Application of patella reduction combined with lateral retinacular release in patients with degenerative osteoarthritis of knee during unilateral total knee arthroplasty

CHEN Changsheng.(Dept. of Orthopedics, New Area People’ s Hospital of Luoyang, Luoyang 471000, China)

Abstract Objective: To investigate the application of patella reduction combined with lateral retinacular release to patients with degenerative osteoarthritis(DOA)of knees during unilateral total knee arthroplasty (TKA). Methods: The clinical data of 98 patients with TKA were retrospectively analyzed, and the patients were divided into two groups according to different surgical methods: Group A(n=45)and Group B(n=53). Group A underwent patella reduction combined with lateral retinacular release during unilateral TKA, while Group B received patella reduction during unilateral TKA. Then, the incidence of anterior knee pain and poor patella track, knee and patella functions, and the incidence of complications before and after surgery were compared between the two groups. Results: The incidence of anterior knee pain in group A was lower than that in group B (6.67% vs 22.64%) (P<0.05); one year after surgery, knee society score(KSS)and patella score(Feller)in group A were higher than those in group B(P<0.05); and there was no significant difference in the incidence of complications between the two groups(P>0.05). Results: In unilateral TKA, the application of patella reduction combined with lateral retinacular release can reduce the incidence of anterior knee pain in patients with DOA of knee, improve knee and patella functions, without increasing the incidence of complications in patients.

Keywords: total knee arthroplasty(TKA); patella reduction; lateral retinacular release; degenerative osteoarthritis(DOA)of knee

参考文献:

[1] 陆永春,毕波,项永胜,等.关节镜下病灶清理治疗老年膝关节退行性骨关节炎的有效性及安全性:非随机对照临床试验方案[J].中国组织工程研究,2018,22(7):1084-1089.

[2] 祁文静,杨延砚,周谋望.全膝关节置换术前康复的研究进展[J].中国康复医学杂志,2019,34(8):980-983.

[3] 杨波,黄向辉,凌鸣,等.全膝关节置换术治疗膝骨性关节炎的临床效果[J].临床骨科杂志,2018,21(4):459-462.

[4] 舒云均.全膝关节置换术中外侧支持带松解对临床疗效的影响[J].实用骨科杂志,2017,23(9):790-793,806.

[5] 中华医学会骨科学分会.骨关节炎诊治指南(2007 年版)[J].中国医刊,2007,42(12):30-32.

[6] 贾承奇,倪明,付君,等.人工全膝关节置换术中髌骨置换对疗效影响的比较研究[J].中国修复重建外科杂志,2018,32(4):394-399.

[7] 潘永谦,王簕,麦伟文.保留和置换髌骨对全膝关节置换术中髌股关节轨迹不良临床效果的影响[J].生物骨科材料与临床研究,2018,15(3):71-72,76.

[8] 吴毅.老年膝骨关节炎的康复治疗[J].老年医学与保健,2019,25(5):554-556.

[9] 杨立,贾云柱,赵明宇.温针灸改善膝关节退行性骨关节炎患者关节功能临床研究[J].陕西中医,2020,41(8):1159-1161.

[10] 张卫超,姜磐,崔卫国,等.玻璃酸钠腔内注射联合关节镜清理术治疗退行性膝骨关节炎的效果及安全性观察[J].临床误诊误治,2021,34(2):34-38.

[11] 王硕,刘启明,顾红卫,等.退行性膝骨关节炎患者的外科治疗研究进展[J].医疗装备,2020,33(12):191-193.

[12] LEICHTLE U G,WÜNSCHEL M,LEICHTLE C I,et al.Increased patellofemoral pressure after TKA: an in vitro study[ J]. Knee Surg Sports Traumatol Arthrosc, 2014,22(3):500-508.

[13] 赵传喜,曾明珠,曾子全,等.髌骨缩小联合外侧支持带松解对膝关节置换术的疗效影响[J].中华关节外科杂志(电子版),2019,13(2):168-172,241.

[14] 贾钧策,翁习生.初次全膝关节置换术后前膝痛与髌骨处理的研究进展[J].中华关节外科杂志(电子版),2020,14(5):619-622.

[15] 朱永良,李煜明,颜超,等.外侧支持带松解对人工全膝关节置换术后膝前痛的影响[J].中国修复重建外科杂志,2017,31(5):541-546.

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