在印度西部的一个亚群中,采用非髌骨表面置换技术治疗膝关节炎患者的全膝关节置换术的结果和分析

Umang R Barot, Milan M. Chaudhari, K. Bhan
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摘要

引言:全膝关节置换术中髌骨表面重建的决定仍然存在争议。尽管一些外科医生为了避免增加术后膝关节前侧疼痛和再次手术的风险,常规地对髌骨进行表面处理,但也有一些外科医生基于膝关节前侧疼痛的存在选择性地进行表面处理,尤其是关节软骨受损、炎症性关节炎、孤立性髌骨股骨关节炎、髌骨半脱位和追踪不良。人们常说,全膝关节置换术(TKA)治疗膝关节骨性关节炎时,采用髌骨表面置换和非表面置换技术,其临床和功能结果没有区别。因此,本研究旨在评估非髌骨置换全膝关节置换术的疗效。材料与方法:对50例经影像学证实为骨关节炎临床体征和症状的患者进行手术治疗。用膝关节社会评分和VAS评分测量功能和临床结果。结果:髌骨非表面修复术术前与术后预后差异有统计学意义。平均活动范围(ROM)有显著改善。术前87.2 vs术后104.4。膝关节社会评分(KSS)术前平均39.66 v/s,术后平均83.26 v/s。功能评分从术前的52.5分提高到术后的83.36分。平均视觉模拟评分(VAS)由7.98分降至2分。结论:两组患者术前、术后膝关节社会评分(KSS)和视觉模拟评分(VAS)两项主要指标差异均有统计学意义。
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Outcomes and analysis of total knee arthroplasty with non-patella resurfacing techniques for patients with osteoarthritis of the knee in a subpopulation of Western India
Introduction: The decision to resurface the patella during total knee arthroplasty remains controversial. Even though some surgeons routinely resurface the patella to avoid the increased rates of postoperative anterior knee pain and reoperation for secondary resurfacing, others selectively resurface based on the presence of anterior knee pain, notably damaged articular cartilage, inflammatory arthritis, isolated patellofemoral arthritis, and patellar subluxation and maltracking. It is often said that there is no difference in clinical and functional outcome of Total Knee Arthroplasty (TKA) for knee osteoarthritis using patellar resurfacing and non-resurfacing techniques. Thus, this study was performed to evaluate the outcome of non-patella resurfacing total knee arthroplasty. Materials and Methods: A total of 50 patients in series who came to Ruby Hall Clinic, Pune with clinical signs and symptoms of osteoarthritis confirmed radiologically, were operated. The functional and clinical outcomes with Knee society score and VAS score were measured. Results: There was significant difference in outcome of non-resurfaced patella pre-operatively and postoperatively. There was significant improvement in mean range of motion (ROM). It was 87.2 Pre-op vs 104.4 Post-op. The Knee Society Score (KSS) had a mean Pre-op 39.66 v/s Post-op 83.26. The improvement in functional score was from a Pre-op 52.5 to post-op of 83.36. The mean Visual Analogue Score (VAS) score decreased from 7.98 to 2. Conclusion: The results showed significant difference in both the main indicators of Knee Society Score (KSS) and Visual Analogue Score (VAS), both pre-operatively and post-operatively.
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