【摘要】 目的 回顾分析保留后交叉韧带 (cruciate-retaining，CR) 的单侧全膝关节置换术 (total knee arthroplasty，TKA) 术中髌骨置换与否对术后效果的影响。方法 共纳入 77 例，髌骨置换组 40 例，髌骨成形组 37 例。术后髌骨置换组随访 (20.66±4.43) 个月，髌骨成形组随访 (22.05±4.00) 个月。随访内容包括：美国膝关节协会评分 (American Knee Society Score，KSS)、西安大略和麦克马斯特大学骨关节炎指数评分(Western Ontario and McMaster Universities Osteoarthritis Index，WOMAC)、遗忘关节评分 (forgotten joint score，FJS)、关节活动度 (range of motion，ROM)、膝前痛发生率、患者满意度。所有数据采用 STATA 15.0 软件进行统计学分析。P < 0.05 为差异有统计学意义。结果 髌骨置换组 28 例非常满意 (70.00%)，髌骨成形组 16 例非常满意 (43.24%) (P=0.027)，髌骨置换组的患者可以自如上楼 (P=0.027)，做轻体力家务活 (P=0.015) 和重体力家务活 (P=0.006) 时更加轻松。术后 ROM、KSS、WOMAC、FJS 等指标，两组差异无统计学意义。术后髌骨置换组 4 例出现膝前痛，髌骨成形组 3 例出现膝前痛，差异无统计学意义 (P=0.773)。髌骨置换组 17 例 FJS ≥ 84.38 (42.50%)；髌骨成形组 15 例 FJS ≥ 84.38 (40.54%)。两组差异无统计学意义 (χ~2=0.071，P=0.790)。结论 术后近期，单侧 CR 型 TKA 中髌骨置换组满意度更高。更多还原

【Abstract】 Objective To retrospectively investigate the clinical effect of patella resurfacing in cruciate-retaining (CR) unilateral total knee arthroplasty (TKA).Methods A total of 77 patients from May 2018 to May 2020 were reviewed in this study,with 40 patella resurfacing and 37 patella arthroplasty.The follow-up was (20.66±4.43)months in the patella resurfacing group and (22.05±4.00) months in the patella arthroplasty group.The American Knee Society Score (KSS),Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC),Forgotten Joint Score (FJS) were used.We also assessed range of motion (ROM),anterior knee pain and patient-satisfaction.All statistical analyses were performed using STATA version 15.A two-sided P < 0.05 was deemed statistically significant.Results Twenty-eight (70.00%) patients in the patella resurfacing group were “very satisfied” and sixteen (43.24%) patients in the patella arthroplasty group were “very satisfied” (P=0.027).Patients in the patella resurfacing group were freer when they went upstairs (P=0.027),did light housework (P=0.015) and heavy housework (P=0.006).There were no statistical differences in postoperative ROM,KSS,WOMAC,FJS between the two groups.Four patients reported anterior pain in the patella resurfacing group,while three reported anterior pain in the patella arthroplasty group with no statistical differences (P=0.773).A total of seventeen (42.50%) cases in the patella resurfacing group achieved FJS ≥ 84.38,and fifteen (40.54%) cases in the patella arthroplasty group achieved the goal.There was no statistical difference between the two groups (χ~2=0.071,P=0.790).Conclusions In CR TKA,patients in patella resurfacing group report higher satisfaction.更多还原