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Abstract Objective To investigate the clinical efficacy of arthroscopic patelloplasty combined with lateral retinaculum release in patients with patellofemoral arthritis and the correlation between imaging and gait.Methods From December 2020 to January 2022，a total of 75 patients with patellofemoral arthritis diagnosed in the Department of Orthopedics in Gansu Provincial Hospital of Traditional Chinese Medicine were selected.32 males and 43 females were included.The average age was (56.10±8.17) years old，ranging from 42 to 67 years old.The average course of disease was (4.20±2.44) years.There were 42 cases of left knee and 33 cases of right knee.anteroposterior and lateral X-ray，30 °patellar axial X-ray and knee CT examations were performed before surgery，6 months and 12 months after surgery.Gait tests were performed before surgery and 12 weeks after surgery.The corresponding Insall index，peel index，lateral patellar angle，patellofemoral fit angle，patellar tilt angle and other imaging indicators，as well as gait parameters such as foot distance，gait frequency，gait speed，support time and weight distribution were measured.Pearson correlation analysis was performed between imaging parameters and gait parameters.Results By comparing the imaging indexes and gait parameters before and after treatment，the Insall index，peel index，patellofemoral fitness angle index，lateral patellar angle index and patellar tilt angle index after treatment were significantly improved compared with those before treatment，and the difference was statistically significant (P＜0.05).After treatment，the gait parameters of patients' feet，such as stride distance，gait frequency，support time，weight distribution，were compared.before and after treatment.The gait of patients improved significantly after operation，and the difference was statistically significant (P＜0.05).Pearson correlation analysis showed that there was a certain correlation between the improvement of imaging indicators and gait parameters.The lateral patellar angle was positively correlated with gait，and the correlation coefficient (r value) ranged from 0.512 to 0.682，which was the highest correlation with gait speed.The Insall index，peel index，patellofemoral fit angle and patellar tilt angle were negatively correlated，and the correlation coefficient (r value) ranged from －0.831 to －0.143，which had the highest correlation with weight distribution.Conclusion Arthroscopic patelloplasty combined with lateral retinaculum release can improve the imaging and gait changes of patients with patellofemoral arthritis，and there is a certain correlation between imaging indicators and gait.
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Corresponding Authors:
Liu Zhi
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［1］Zhang Z，Xu F，Yang X.Progress on treatment for patellofemoral arthritis［J］.Zhongguo Gushang，2018，31(7)：684-688.
［2］杨渝平，陈泓宇，赵静文，等.两种外侧支持带松解法治疗髌骨外侧过度挤压综合征的回顾性对照研究［J］.中华外科杂志，2021，59(9)：757-763.
［3］Aksu N，Atansay V，Aksu T，et al.Patellofemoral Chondropathy Areas in Folk Dancers：An MRI study［J］.Med Probl Perform Art，2021，36(1)：34-38.
［4］叶培，董志兴，王立晖，等.髌骨外侧关节面成形联合外侧松解术治疗严重髌股关节炎［J］.临床骨科杂志，2021，24(6)：802-805.
［5］苏柯，桑卫华，王庆海，等.胫骨高位截骨术对髌股关节软骨病变的影响［J］.实用骨科杂志，2021，27(10)：870-874.
［6］谭新访，郭艳幸，秦晓飞，等.顺轴疲劳运动对兔髌股关节软骨损伤的影响［J］.中国组织工程研究，2022，26(14)：2184-2189.
［7］沈佳韵，邢华，龚利，等.髌股关节紊乱对膝骨关节炎影响的研究进展［J］.中医正骨，2021，33(3)：53-55.
［8］王冰，孙海宁，于秀淳，等.髌股关节退变对活动平台人工单髁关节置换手术临床疗效的影响［J］.实用骨科杂志，2020，26(12)：1059-1063.
［9］Goulette D，Griffith P，Schiller M，et al.Patellofemoral joint loading during the forward and backward lunge［J］.Phys Ther Sport，2021(47)：178-184.
［10］SanchisAlfonso V，Koh JL.Joint-preserving osteotomies for isolated patellofemoral osteoarthritis：Alternatives to arthroplasty［J］.Am J Orthop (Belle Mead NJ)，2017，46(3)：139-145.
［11］刘效仿，周观明，管明强，等.髌骨外侧成形术联合外侧支持带松解术治疗髌股关节炎［J］.中华创伤骨科杂志，2018，20(12)：1044-1048.
［12］Yokoyama K，Nakamura R，Otsuka T，et al.Deep anterior lamellar keratoplasty and peripheral lamellar keratoplasty for a case of severe peripheral ulcerative keratitis［J］.Case Rep Ophthalmol，2022，13(1)：9-16.
［13］李朝晖，黎文勇，蓝国波，等.单髁置换术联合髌骨成形术在膝关节双间室病变的疗效分析［J］.实用医学杂志，2021，37(15)：2030-2034.
［14］Mao Y，Marshall B，Price T，et al.Notchplasty alters knee biomechanics after anatomic ACL reconstruction［J］.Knee Surg Sports Traumatol Arthrosc，2020，28(2)：614-621.
［15］Sherman SL，Plackis AC，Nuelle CW.Patellofemoral anatomy and biomechanics［J］.Clin Sports Med，2014，33(3)：389-401.
［16］Brophy RH，Wojahn RD，Lamplot JD.Cartilage restoration techniques for the patellofemoral joint［J］.J Am Acad Orthop Surg，2017，25(5)：321-329.
［17］宋娜，蒋金金，马琪，等.从生物力学角度探讨髌股关节炎的病因［J］.中华物理医学与康复杂志，2020，42(5)：477-480.
［18］阮家诚.基于影像和步态的膝关节骨性关节炎的数字化评估［D］.深圳大学，2020.〖1〗
［19］Lindemann U.Spatiotemporal gait analysis of older persons in clinical practice and research：Which parameters are relevant?［J］.Z Gerontol Geriatr，2020，53(2)：171-178.
［20］姚五平，李玉吉，柳直，等.关节镜下手术治疗髌股关节炎的疗效［J］.临床骨科杂志，2021，24(3)：427-429.
［21］Rutherford D，Baker M，Urquhart N，et al.The effect of a frontal plane gait perturbation bout on knee biomechanics and muscle activation in older adults and individuals with knee osteoarthritis［J］.Clin Biomech (Bristol，Avon)，2022(92)：105574.
［22］Nie Y，Yu Q，Shen B.Impact of tibial component coronal alignment on knee joint biomechanics following fixed-bearing unicompartmental knee arthroplasty：A finite element analysis［J］.Orthop Surg，2021，13(4)：1423-1429.
［23］Siqueira MS，Souto LR，Martinez AF，et al.Muscle activation，strength，and volume in people with patellofemoral osteoarthritis：A systematic review and meta-analysis［J］.Osteoarthritis Cartilage，2022，30(7)：935-944.
［24］Prieto-Alhambra D，Judge A，Javaid MK，et al.Incidence and risk factors for clinically diagnosed knee，hip and hand osteoarthritis：Influences of age，gender and osteoarthritis affecting other joints［J］.Ann Rheum Dis，2014，73(9)：1659-1664. |
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