孙彦+顾宣歆（等）

[摘要] 目的 比较髌骨成形术与传统膝关节置换术治疗膝关节骨性关节炎的临床效果。 方法 选择2011年7月～2012年12月于浙江省海宁市人民医院住院并行手术治疗的膝关节骨性关节炎患者109例，其中，行髌骨成形术48例（髌骨成形术组），行传统膝关节置换术61例（传统膝关节置换术组），记录其术前、术后1周及术后2个月的VAS评分和KSS评分。 结果 髌骨成形术组术前、术后1周及术后2个月的VAS评分分别为（7.12±1.91）、（5.65±1.30）、（4.11±1.69）分，KSS评分分别为（48.12±11.88）分、（53.34±7.34）分、（65.12±5.37）分；传统膝关节置换术组术前、术后1周及术后2个月的VAS评分分别为（7.59±2.41）、（4.55±1.69）、（2.35±1.28）分，KSS评分分别为（30.25±10.95）、（66.55±10.37）、（78.01±13.12）分；传统膝关节置换术组术后1周及术后2个月的VAS评分均较髌骨成形术组低，KSS评分均较髌骨成形术组高，差异均有统计学意义（均P < 0.05）。 结论 对于治疗中晚期骨性关节炎，传统膝关节置换术较髌骨成形术效果更佳。

[关键词] 膝关节骨性关节炎；髌骨成形术；传统膝关节置换术

[中图分类号] R684.3 [文献标识码] A [文章编号] 1673-7210（2014）10（a）-0035-05

Clinical observation of patellar arthroplasty and traditional knee arthroplasty in the treatment of knee osteoarthritis

SUN Yan1 GU Xuanxin1 QIAN Yuening1 GU Xiaomin2

1.The First Department of Orthopedics， the People's Hospital of Haining City， Zhejiang Province， Haining 314400， China； 2.Department of Orthopaedics， the Second People's Hospital of Hangzhou City， Zhejiang Province， Hangzhou 310015， China

[Abstract] Objective To discuss the clinical effects of patellar arthroplasty and traditional knee arthroplasty in the treatment of knee osteoarthritis. Methods 109 patients with knee osteoarthritis underwent operative treatment in the People's Hospital of Haining City from July 2011 to December 2012 were selected. 48 cases were given patellar arthroplasty treatment （patellar arthroplasty group）， 61 cases were given traditional knee arthroplasty treatment （traditional knee arthroplasty group）. The VAS score and KSS score before operation， 1 week and 2 months after operation were recorded. Results The VAS scores before operation， 1 week and 2 months after operation in the patellar arthroplasty group were （7.12±1.91）， （5.65±1.30）， and （4.11±1.69） scores， while the KSS scores were （48.12±11.88）， （53.34±7.34）， （65.12±5.37） scores. The VAS scores before operation， 1 week and 2 months after operation in the traditional knee arthroplasty group were （7.59±2.41）， （4.55±1.69）， （2.35±1.28） scores， while the KSS scores were （30.25±10.95）， （66.55±10.37）， （78.01±13.12） scores. 1 week and 2 months after operation， the VAS scores of patients in the traditional knee arthroplasty group were lower than those in the patellar arthroplasty group， while the KSS scores were higher than those of in the patellar arthroplasty group， the differences were statistically significant （P < 0.05）. Conclusion The effect of patellar arthroplasty in the treatment of middle-late osteoarthritis is worse than traditional knee arthroplasty.

[Key words] Knee osteoarthritis； Patellar arthroplasty； Traditional knee arthroplasty

膝关节骨性关节炎是一种由于膝关节内软骨变性及骨质增生引起的慢性老年性疾病，容易导致膝关节畸形、疼痛、功能障碍，严重影响患者的生活质量。该病的病理特点为膝关节边缘骨质的增生、关节软骨破坏或变性、软骨下囊性变或骨硬化、膝关节滑膜的增生、关节囊不同程度的挛缩、膝关节内韧带挛缩或松弛、肌肉出血萎缩甚至无力等。该病发病原因目前尚不明确，但与年龄、创伤、体重、生活习惯、遗传、工作等因素有关[1]。

随着中国人口老龄化的发展以及生活质量提高，膝关节骨性关节炎的发病逐渐增多并有年轻化的趋势。……