老年固定性髌脱位骨关节炎髌骨旷置全膝置换
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西藏自治区人民政府驻成都办事处医院

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西藏自治区科技计划联合资助项目(编号:CGZH2022001096) 中央引导地方科技发展资金项目(编号:ZYYD2020000042)


Total knee arthroplasty and absence of patella for treatment of osteoarthritis with permanent irreducible dislocation of patella in the elderly
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Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region

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西藏自治区科技计划联合资助项目(编号:CGZH2022001096) 中央引导地方科技发展资金项目(编号:ZYYD2020000042) Project jointly funded by the Science and Technology Program of Tibet Autonomous Region (No.: CGZH2022001096) Central Leading Local Science and Technology Development Fund Project (No.: ZYYD2020000042)

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    摘要:

    [目的]介绍髌骨旷置全膝置换治疗老年固定性髌骨脱位骨关节炎的手术技术及初步疗效。[方法]对4例(5膝)老年膝骨关节炎伴固定性髌骨脱位患者,采用前交叉韧带替代型或限制性假体行全膝关节置换(TKA),沿髌骨内侧切开关节囊,髌骨予以修整成形,去神经化,并做外侧支持带松解,判断髌骨仍无法复位,将髌骨旷置于外侧间沟,行TKA后缝合关节囊。[结果] 所有患者均顺利完成手术,术中无并发症,术后第1d下地行走,术后伤口无感染。4例患者随访时间 3~5年,末次随访关节稳定,VAS评分及HSS评分均为优良,但卧位状态下仍有10°~25°的伸膝迟滞。[结论]对于老年膝关节OA伴固定性髌骨脱位,若患者功能需求不高,TKA术中可采用髌骨旷置,疗效满意,可作为临床治疗的一种选择。

    Abstract:

    [Objective] To Introduce the surgical technique and preliminary efficacy of absence of patella and total knee replacement in the treatment of senile fixed patellar dislocation osteoarthritis. [Method] For 4 cases (5 knee) elderly knee osteoarthritis with fixed patella dislocation, total knee replacement (TKA) was cut along the medial patella, the patella was trimmed, degenerated, and the patella cannot be reset, the patella was opened in the lateral sulcus, and the joint capsule was closed after TKA. [Results] All patients completed the operation without intraoperative complications, walking on the first d and no infection in the postoperative wound. Four patients were followed-up for 3 to 5 years, and the last follow-up had stable joints, and the VAS score and HSS score were excellent, but they remained delayed from 10 ° to 25 ° in decubitus position. [Conclusion] For elderly knee OA with fixed patella dislocation, if the functional demand of patients is not high, patella relaxation can be used in TKA, with satisfactory efficacy and can be used as an option for clinical treatment.

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  • 收稿日期:2022-10-28
  • 最后修改日期:2023-01-09
  • 录用日期:2023-04-11
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