| 类风湿膝关节置换术中髌下脂肪垫切除与否对髌骨高度的影响 |
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投稿时间：2020-07-21
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| 作者 | Author | 单位 | Address | E-Mail |
| 李龙杰 |
LI Long-jie |
沧州市中心医院运动医学科, 河北 沧州 061001 |
Department of Sports Medicine, Cangzhou Central Hospital, Cangzhou 061001, Hebei, China |
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| 张海森 |
ZHANG Hai-sen |
沧州市中心医院运动医学科, 河北 沧州 061001 |
Department of Sports Medicine, Cangzhou Central Hospital, Cangzhou 061001, Hebei, China |
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| 陈思 |
CHEN Si |
沧州市中心医院运动医学科, 河北 沧州 061001 |
Department of Sports Medicine, Cangzhou Central Hospital, Cangzhou 061001, Hebei, China |
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| 刘畅 |
LIU Chang |
沧州市中心医院运动医学科, 河北 沧州 061001 |
Department of Sports Medicine, Cangzhou Central Hospital, Cangzhou 061001, Hebei, China |
136321393@qq.com |
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| 期刊信息：《中国骨伤》2020年，第33卷，第10期，第922-927页 |
| DOI：10.12200/j.issn.1003-0034.2020.10.007 |
| 基金项目: |
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中文摘要:
目的：比较类风湿关节炎膝关节置换术中切除或保留髌下脂肪垫对术后髌骨高度的影响。
方法：回顾性分析2013年10月至2017年10月行全膝关节置换术的类风湿关节炎患者48例，分为切除及保留髌下脂肪垫组。切除组23例，男9例，女14例；年龄48～69（55.83±5.65）岁；术中采取常规切除髌下脂肪垫。保留组25例，男6例，女19例；年龄49～70（55.52±6.28）岁；术中采取完整保留髌下脂肪垫。观察两组患者术后并发症情况，术后1年采用视觉模拟疼痛评分（visual analogue scale，VAS）评价疼痛缓解程度，采用美国特种外科医院（Hospital for Specical Surgery，HSS）评分进行膝关节疗效评价，并采用Insall-Salvati比值法（I-S比）比较两组术后髌骨高度改变情况。
结果：所有患者获得随访，时间12～39（23.85±8.82）个月。两组患者术后伤口愈合良好，未发生感染并发症，术后随访无假体松动、翻修发生。两组术后1年VAS评分较术前明显降低，但术后1年两组间VAS评分比较差异无统计学意义（P>0.05）。术后1年两组HSS评分较术前改善（P<0.05），但术后1年两组之间HSS评分比较差异无统计学意义（P>0.05）。术后1年切除组I-S比（1.03±0.04）小于髌下脂肪垫保留组（1.06±0.06），差异有统计学意义（P<0.05）。
结论：类风湿关节置换术中切除或保留髌下脂肪垫在术后疼痛缓解及功能恢复方面都能获得良好疗效，但术中保留髌下脂肪垫有利于髌骨高度的恢复。 |
| 【关键词】类风湿,关节炎 关节成形术,置换,膝 脂肪组织 |
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| Influence of retention or resection subpatellar fat pad on patella height during rheumatoid knee replacement |
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ABSTRACT
Objective: To compare influence of retention or resection subpatellar fat pad on patella height during rheumatoid knee replacement.
Methods: Totally 48 patients with rheumatoid arthritis who underwent total knee replacement from October 2013 to October 2017 were retrospectively analyzed and divided into resection and retention subpatellar fat pad group. There were 23 patients in resection subpatellar fat pad group,including 9 males and 14 females aged from 48 to 69 years old with an average of(55.83±5.65) years old; subpatellar fat pad were resected during opertaion. There were 25 patients in retention subpatellar fat pad group,including 6 males and 19 femlaes aged from 49 to 70 years old with an average age of (55.52±6.28) years old;subpatellar fat pad were retented during opertaion. Postopertaive complications were observed between two groups,visual analogue scale (VAS) and Hospital for Special Surgery (HSS) at 1 year after operation were used to evaluate relieve pain degree and clnical effect of knee joint,Insall-Salvati ratio(I-S ratio) was used to compare changes of postoperative patella height at 1 year after operation.
Results: All patients were followed up from 12 to 39 months with an average of(23.85±8.82) months. The postoperative wound healed well without infection complications and no prosthetic loosening or revision. Postoperative VAS score at 1 year between two groups was lower than that of before opertaion(P<0.05),but no statistical difference between two groups at 1 year after operation(P>0.05). Postopertaive HSS score between two groups was higer than that of before operation(P<0.05),while no difference in HSS score at 1 year after operation between two groups (P>0.05). I-S ratio of subpatellar fat pad resection group(1.03±0.04) was lower than that of subpatellar fat pad retention group (1.06±0.06),and difference was statistically significant (P<0.05).
Conclusion: Resection or retention subpatellar fat pad in rheumatoid knee replacement have advantages of relieving postoperative pain and improving functional recovery,however,retention of infrapatellar fat pad is beneficial to restoration of patellar height. |
| KEY WORDS Arthritis,rheumatoid Arthroplasty,replacement,knee Adipose tissue |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李龙杰,张海森,陈思,刘畅.类风湿膝关节置换术中髌下脂肪垫切除与否对髌骨高度的影响[J].中国骨伤,2020,33(10):922~927 |
| 英文格式: | LI Long-jie,ZHANG Hai-sen,CHEN Si,LIU Chang.Influence of retention or resection subpatellar fat pad on patella height during rheumatoid knee replacement[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(10):922~927 |
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