[1]陈文恒.全膝关节置换术中保留髌下脂肪垫对近期临床疗效的影响[J].新乡医学院学报,2018,35(2):136-139.[doi:10.7683/xxyxyxb.2018.02.014]
　CHEN Wen-heng.Effect of total knee replacement with preservation of the patellar fat pad on short-term clinical outcomes[J].Journal of Xinxiang Medical University,2018,35(2):136-139.[doi:10.7683/xxyxyxb.2018.02.014]
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全膝关节置换术中保留髌下脂肪垫对近期临床疗效的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年2
页码:
136-139
栏目:
临床研究
出版日期:
2018-02-05

文章信息/Info

Title:
Effect of total knee replacement with preservation of the patellar fat pad on short-term clinical outcomes
作者:
陈文恒
（驻马店市中心医院骨科，河南　驻马店　463000）
Author(s):
CHEN Wen-heng
（Department of Orthopaedics，the Central Hospital of Zhumadian City，Zhumadian 463000，Henan Province，China）
关键词:
髌下脂肪垫; 全膝关节置换术; 髌腱短缩; 膝前痛
Keywords:
patellar fat pad; total knee replacement; patellar tendon shortening; anterior knee pain
分类号:
R687.4+2
DOI:
10.7683/xxyxyxb.2018.02.014
文献标志码:
A
摘要:
目的　探讨全膝关节置换术中保留髌下脂肪垫对近期临床疗效的影响。方法　选择2012年5月至2016年5月在驻马店市中心医院行全膝关节置换术的终末期骨关节炎患者82例，将患者分为切除组和保留组，每组41例。2组患者全身麻醉后均予以全膝关节置换术，其中切除组患者在术野暴露过程中彻底切除髌下脂肪垫；保留组患者在术中保留或部分保留髌下脂肪垫。对2组患者进行1 a随访，评估患者术前及术后1 a的膝关节功能评分、膝关节活动度、膝前疼痛评分，并对2组患者术后1 a的髌腱短缩程度及膝前疼痛发生率进行统计。结果　2组患者术前膝评分、功能评分、膝前疼痛评分、膝关节活动度比较差异均无统计学意义（P>0.05）。2组患者术后1 a膝评分、功能评分及屈膝度均显著高于术前，膝前疼痛评分及屈曲挛缩度均显著低于术前（P<0.05）。2组患者术后1 a膝评分、功能评分、屈膝度及屈曲挛缩度比较差异均无统计学意义（P>0.05），但是保留组患者膝前疼痛评分显著低于切除组（P<0.05）。2组患者术后1周髌腱长度比较差异无统计学意义（P>0.05），术后 1 a保留组患者髌腱长度大于切除组（P<0.05），髌腱短缩长度小于切除组（P<0.05）。切除组和保留组患者术后1 a膝前疼痛发生率分别为22.0%（9/41）和2.4%（1/41），保留组患者膝前疼痛发生率显著低于切除组（χ2=7.29，P<0.01）。结论　全膝关节置换术中保留髌下脂肪垫可显著改善患者的膝前疼痛，降低术后髌腱短缩程度。
Abstract:
Objective　To explore the effect of total knee replacement with preservation of the patellar fat pad on short-erm clinical outcomes.Methods　Eighty two patients with end-stage osteoarthritis were treated by total knee arthroplasty in the Central Hospital of Zhumadian City from May 2012 to May 2016 were randomly divided into resection group and reservation group，with 41 patients in each group.Patients in the two groups were given total knee replacement after general anesthesia，the patients in the resection group underwent a complete resection of the patellar fat pad during exposure to the field，while the patellar fat pad was retained partly or completely during the operation in the preservation group.Patients in the two groups were followed up for one year.The knee function score，knee mobility and anterior knee pain score before operation and one year after surgery were evaluated.Patellar tendon shortening and incidence of anterior knee pain of patients in the two groups were analyzed at one year after surgery.Results　There was no significant difference in the knee score，functional score，anterior knee pain score and knee mobility before operation between the two group（P>0.05）.At one year after operation，the knee score，functional score and knee flexion degree were higher，while the anterior knee pain score and flexion contracture were lower than those before operation in the two groups（P<0.05）.There was no significant difference in the knee score，functional score，knee flexion degree and flexion contracture at one year after operation between the two groups（P>0.05），but the anterior knee pain score in the preservation group at one year after operation was lower than that in the resection group（P<0.05）.There was no significant difference in the length of patellar tendon at one week after operation between the two groups（P>0.05）.The length of patellar tendon was longer and the length of patellar tendon shortening in the preservation group at one year after operation was lower than that in the resection group（P<0.05）.The incidence of anterior knee pain at one year after operation in the resection group and the preservation group was 22.0%(9/41) and 2.4%(1/41)，respectively.The incidence of anterior knee pain at one year after operation in the preservation group was lower than that in the resection group（χ2=7.29，P<0.01）.Conclusion　To remain the patellar fat pad in the total knee replacement can improve the condition of anterior knee pain and decrease the degree of patellar tendon shortening after operation.

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更新日期/Last Update: 2018-02-05