髌股关节置换治疗髌股关节骨关节炎的临床研究

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (3070 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the clinical efficacy，surgical techniques and intraoperative precautions of patellofemoral arthroplasty(PFA) for patellofemoral osteoarthritis(PFOA).Methods A retrospective analysis of 146 knees in 134 patients with PFOA treated by PFA surgery in our department from August 2013 to December 2019，including 46 males and 88 females，aged 48~73 (52.4±7.6) years old.86 cases of left knee and 60 cases of right knee were included.According to Dejour classification，there were 23 knees of Type A，49 knees of Type B，54 knees of Type C，20 knees of Type D.The course of disease was 8 to 53 (17.1±3.2) months，and the patients were evaluated by preoperative VAS score and Lysholm knee joint score.Complications such as joint infections and hematomas after the operation were followed up at 1 month，3 months，2 years，and 4 years after the operation.The front and side Xrays of the knee joint and the patella axial film were taken and recorded VAS，Lysholm scores，efficacy evaluation，and patient satisfaction were statistically analyzed.Results The average follow-up time was 17 to 53 (32.1±6.8) months.The postoperative wounds of 134 patients of 146 knees healed at grade I，with a high degree of satisfaction.The effective rate of treatment was 97.95%.The VAS score was based on the preoperative score of (8.43±1.31).It descends to (1.43±0.19) points three months after surgery，and the VAS score reached (0.13±0.02) points at the last followup.The difference was statistically significant (P＜0.05).The Lysholm knee score increased from (46.08±2.08) points before surgery to (88.65±0.61) points three months after surgery，and reached (97.92±0.49) points at the last followup.The difference was statistically significant (P＜0.05).During the follow-up，1 case of knee pain with tilted patella，2 cases of patellofemoral joint snapping and patellar subluxation，all the above 3 patients underwent revision surgery，1 case had lower patella after revision，and no revision was performed again.The remaining patients did not Complications such as dislocation of the patella and loosening of the prosthesis occurred.Conclusion The second-generation prosthetic PFA surgery can solve the problem of patellofemoral joint osteoarthritis.It is an effective treatment for PFOA after failure of non-surgical treatment.In clinical practice，the indications and contraindications of PFA should be strictly grasped.Grasp the correct operation points during the operation，and take active rehabilitation exercise guidance after the operation.The effect is good.The treatment method is worthy of clinical promotion.

Key words： knee patellofemoral joint osteoarthritis replacement

Corresponding Authors: Jing Lin

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Liu Siye
	Jing Lin
	Zhang Hongmei
	Yan Qi
	Tang Jixiang
	Li Yan
	Ai Qi

Cite this article:

Liu Siye,Jing Lin,Zhang Hongmei, et al. A Clinical Study of Patellofemoral Joint Replacement in the Treatment of Patellofemoral Joint Osteoarthritis[J]. sygkzz, 2023, 29(6): 491-.

URL:

http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2023/V29/I6/491

［1］Csintalan RP，Schulz MM，Woo J，et al.Gender differences in patellofemoral joint biomechanics［J］.Clin Orthop Relat Res，2002(402)：260-269.〖1〗
［2］Leadbetter WB.Patellofemoral arthroplasty in the treatment of patellofemoral arthritis：rationale and outcomes in younger patients［J］.Orthop Clin North Am，2008，39(3)：363-380.
［3］Kim YM，Joo YB.Patellofemoral osteoarthritis［J.Knee Surg Relat Res，2012，24(4)：193-200.
［4］雷光华.髌股关节骨关节炎的诊疗现状［J］.医学临床研究，2020，37(5)：641-645.
［5］肖文峰，高曙光，杨佩，等.髌股关节骨关节炎手术治疗专家共识［J/OL］.中国修复重建外科杂志，2021，35(1)：1-7
［6］Ackroyd CE，Newman JH，Evans R，et al.The Avon patellofemoral arthroplasty：five-year survivorship and functional results［J］.J Bone Joint Surg (Br)，2007，89(3)：310-315.
［7］国家老年疾病临床医学研究中心 (湘雅医院) 中华医学会骨科学分会关节外科学组.中国髌股关节骨关节炎诊疗指南 (2020年版).中华骨科杂志，2020，40(18)：1227-1234.
［8］Li Z，Liu Q，Zhao C，et al.High prevalence of patellofemoral osteoarthritis in China：A multi-center population-based osteoarthritis study［J］.Clin Rheumatol，2020，39(12)：3615-3623.
［9］Ackroyd CE，Newman JH，Evans R，et al.The Avon patellofemoral arthroplasty：five year survivorship and functional results［J］.J Bone Joint Surg (Br)，2007，89(3)：310-315.
［10］Leadbetter WB，Kolisek FR，Levitt RL，et al.Patellofemoral arthroplasty：A multicentre study with minimum 2 years follow-up［J］.Int Orthop，2009，33(6)：1597-1601.
［11］Sisto DJ，Sarin VK.Custom patellofemoral arthroplasty of the knee［J］.J Bone Joint Surg (Am)，2006，88(7)：1475-1480.
［12］Davies AP，Vince AS，Shepstone L，et al.The radiologic prevalence of patellofemoral osteoarthritis［J］.Clin Orthop Relat Res，2002(402)：206-212.
［13］周英祝，王强.关节镜治疗轻、中度髌股关节炎疗效探讨［J］.实用骨科杂志，2012，18(8)：704-706
［14］金晓飞，郭长青，蒋昭霞，等.膝骨关节炎模型内侧副韧带的生物力学特性［J］.中国组织工程研究，2011，15(43)：8046-8049.
［15］Stefanik JJ，Duncan R，Felson DT，et al.Diagnostic performance of clinical examination measures and pain presentation to identify patellofemoral joint osteoarthritis［J］.Arthritis Care Res (Hoboken).2018 Jan；70(1)：157-161.doi：10.1002/acr.23238.PMID：28320074.
［16］Mthalko WM，Boachie-Adjiei Y，Apanq JT，et al.Controversies and techniques in the surgical management of patellofemoral arthritis［J］.Instr Course Lect，2008，57(13)：365-380.
［17］Pinkowsky GJ，Farr J.Considerations in evaluating treatment options for patellofemoral cartilage pathology.Sports Med Arthrosc Rev，2016，24(2)：92-97.
［18］Shanmugaraj A，Coughlin RP，Kuper GN，et al.Changing trends in the use of cartilage restoration techniques for the patellofemoral joint：A systematic review［J］.Knee Surg Sports Traumatol Arthrosc，2019，27(3)：854-867.
［19］Li B，Bai L，Fu Y，et al.Comparison of clinical outcomes between patellar resurfacing and nonresurfacing in total knee arthroplasty：retrospective study of 130 cases［J］.Int Med Res，2012，40(5)：1794-1803.
［20］Cuthbert R，Tibrewal S，Tibrewal SB.Patello\fe=\[moral arthroplasty：current concepts［J］.J Clin Orthop Trauma，2018，9(1)：24-28.
［21］Bunyoz KI，Lustig S，Troelsen A.Similar postoperative patientreported outcome in both second generation patellofemoral arthroplasty and total knee arthroplasty for treatment of isolated patellofemoral osteoarthritis：A systematic review［J］.Knee Surg Sports Traumatol Arthrosc，2019，27(7)：2226-2237.
［22］冯明光，吴海山.髌股关节置换术进展［J］.国际骨科学杂志，2014，35(1)：27-35.
［23］Cartier P，Sanouiller JL，Khefacha A.Longterm results with the first patellofemoral prosthesis［J］.Clin Orthop ReLat Res，2005(436)：47-54.
［24］Hoogervorst P，DE Jong RJ，Van Kampen A，et al.A 21% conversion rate to total knee arthroplasty of a first-generationpatellofemoral prosthesis at a mean follow-up of 9.7 years［J］.Int Orthop，2015，39(9)：1857-1864.
［25］Lonner JH.Patellofemoral arthroplasty：Pros，cons，and design considerations［J］.Clin Orthop Relat Res，2004(428)：158-165.
［26］Lonner JH，Mehta S，Booth RE Jr.Ipsilateral patellofemoral arthroplasty and autogenous osteochondral femoral condylar transplantation［J］.J Arthroplasty，2007，22(8)：1130-1136.
［27］Argenson JN，Flecher X，Parratte S，et al.Patellofemoral arthroplasty：An update［J］.Clin Orthop Relat Res，2005(440)：50-53.
［28］李仁明，李忠，刘俊才.髌股关节置换治疗单纯髌股关节骨关节炎的近期疗效分析［J］.西南军医，2016，18(5)：429-432.
［29］王红辉.应用髌股关节置换术治疗膝关节髌股骨关节炎的中短期疗效观察［J］.中国医学工程，2016，24(3)：45-46.
［30］Williams DP，Pandit HG，Athanasou NA，et al.Early revisions of the femoro patella vialla joint replacement［J］.Bone Joint J，2013，95(6)：793-797.
［31］Oni JK，Hochfelder J，Dayan A.Isolated patellofemoral arthroplasty［J］.Bull Hosp Jt Dis (2013)，2014，72(1)：97-103.
［32］Sabatini L，Schiro M，Atzori F，et al.Patellofemoral joint arthroplasty：our experience in isolated patellofemoral and bicompartmental arthritic knees［J］.Clin Med Insights Arthritis Musculoskelet Disord，2016(9)：189-193.
［33］Lonner JH.Patellofemoral arthroplasty［J］.J Am Acad Orthop Surg，2007，15(8)：495-506.
［34］Lustig S，Fleury C，Goy D，et al.The accuracy of acquisition of an imageless Computer-assisted system and its implication for knee arthroplasty［J］.Knee，2011，18(1)：15-20.
［35］Cossey AJ，Spriggins AJ.Computer-assisted patellofemoral arthroplasty：A mechanism for optimizing rotation［J］.J Arthroplasty，2006，21(3)：420-427.