南方医科大学学报

南方医科大学学报 ›› 2022, Vol. 42 ›› Issue (2): 244-249.doi: 10.12122/j.issn.1673-4254.2022.02.11

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全膝关节置换术中采用内侧髌旁软组织重叠缝合法处理重度膝关节骨关节炎合并固定性髌骨脱位的早中期临床结果

牛 鸣，王秋入，李军伟，王 同，吴旭年，蔡经纬，王旭勃，康鹏德   

  1. 张掖市甘州区人民医院骨科，甘肃 张掖 734000；四川大学华西医院骨科，四川 成都 610041
  • 出版日期:2022-02-20 发布日期:2022-03-16

Medial parapatellar soft tissue overlapping suture in total knee arthroplasty for severe osteoarthritis with permanent patellar dislocation: early and mid-term results

NIU Ming, WANG Qiuru, LI Junwei, WANG Tong, WU Xunian, CAI Jingwei, WANG Xubo, KANG Pengde   

  1. Department of Orthopedics, Ganzhou District People's Hospital, Zhangye 734000, China; Department of Orthopedics, Sichuan University West China Hospital, Chengdu 610041, China
  • Online:2022-02-20 Published:2022-03-16

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摘要： 目的 回顾性分析在全膝关节置换术中采用内侧髌旁软组织结构重叠缝合法处理重度骨关节炎合并固定性髌骨脱位的早中期临床结果。方法 在全膝关节置换术中采用内侧髌旁软组织结构重叠缝合法治疗12例重度膝关节骨关节炎合并固定性髌骨脱位的患者。美国膝关节协会评分、加州大学洛杉矶分校活动等级评分、视觉模拟（VAS）疼痛评分比较术前和术后2年情况及膝关节活动度。影像学检查患者膝关节正侧位、双下肢站立位全长和髌骨轴位复位情况。结果 患者的美国膝关节协会评分由术前的34.2±11.1分提高到术后2年73.5±6.3分（P<0.001）。加州大学洛杉矶分校活动等级评分由术前的3.8±0.8分提高到术后2年5.8±0.6分（P=0.003）。VAS 疼痛评分由术前的42.8±6.0分下降到术后2年20.1±3.7（P<0.001）。膝关节活动度由术前74.6±8.9度提高到术后2年97.5±4.5度（P<0.001）。影像学显示所有患者髌骨未见半脱位或脱位征象。结论 在全膝关节置换术中采用特殊的内侧髌旁软组织结构重叠缝合法处理重度骨关节炎合并固定性髌骨脱位，可以取得令人满意的早中期临床结果。

关键词: 全膝关节置换术；重叠缝合；骨关节炎；固定性髌骨脱位

Abstract: Objective To evaluate the early and mid-term clinical results of medial parapatellar soft tissue overlapping suture in total knee arthroplasty for treatment of severe osteoarthritis combined with permanent patellar dislocation. Methods We retrospectively analyzed the data of 12 patients (12 knees) diagnosed with severe knee osteoarthritis combined with permanent patellar dislocation undergoing total knee arthroplasty with medial parapatellar soft tissue overlapping suture. Knee Society Score (KSS), University of California Los Angeles (UCLA) activity-level rating, Visual Analog Scale (VAS) pain score, and knee range of motion of the patients were assessed before and 2 years after the surgery. Anteroposterior and lateral radiographs of the knee joint, full-length standing radiographs of the lower limbs and patellar axial radiographs were evaluated. Results The mean Knee Society Score of the patients increased from 34.2±11.1 before surgery to 73.5±6.3 at two years after the surgery (P<0.001). The UCLA activity-level rating increased from an average of 3.8 ± 0.8 before surgery to 5.8 ± 0.6 at two years postoperatively (P=0.003). The mean VAS pain score decreased from 42.8±6.0 before surgery to 20.1±3.7 (P<0.001) and the range of motion of the knee joint increased from 74.6±8.9 degrees to 97.5±4.5 degrees at two years (P<0.001). The radiographs showed no signs of subluxation or dislocation of the patella in all the patients. Conclusions Medial parapatellar soft tissue overlapping suture in total knee arthroplasty can achieve good early and mid-term clinical results for treatment of severe osteoarthritis combined with permanent patellar dislocation.

Key words: total knee arthroplasty; overlapping suture; osteoarthritis; permanent patellar dislocation