标题：膝关节置换术中髌骨置换对骨关节炎患者预后及生存率的影响

      作者：王大城，巫洪波，郭汉明    (惠州市中心人民医院关节外科，广东 惠州 516001)

      卷次： 2017年28卷18期

      【摘要】 目的 探讨膝关节置换术中髌骨置换对骨关节炎患者预后及生存率的影响。方法 回顾性分析2012年1月至2014年4月我院收治的120例膝关节骨关节炎患者(共120膝)的临床资料，其中术中置换髌骨(观察组)或不置换髌骨(对照组)者各60例。术后随访2年，采用KSS膝评分与功能评分、髌骨评分(PS)、疼痛视觉模拟评分(VAS)评价并比较两组患者的膝关节功能，应用生存曲线比较两组患者的生存率。结果 两组患者术后6周、3个月、6个月、1年的KSS膝评分、KSS功能评分、PS评分均明显高于术前，而VAS评分低于术前，差异均具有统计学意义(P<0.05)；同时，观察组术后 6个月、1年的KSS功能评分分别为(80.4±13.8)分、(88.4±6.1)分、PS评分分别为(19.6±4.6)分、(24.9±4.2)分，明显高于对照组的(67.6±11.2)分、(76.3±12.4)分和 (17.1±3.3)分、(18.5±2.2)分，而VAS评分[(3.3±1.1)分、(2.4±0.9)分]低于对照组[(4.3±1.3)分、(3.5±1.1)分]，差异均具有统计学意义(P<0.05)；术后 2年两组患者的髌骨倾斜角、髌骨适合角、胫骨角、髌韧带比值及生存率比较差异均无统计学意义(P>0.05)。结论 在全膝关节置换术中置换髌骨可明显提高患者膝关节功能，减轻疼痛，而对2年生存率无明显影响。
      【关键词】 髌骨；全膝关节置换术；生存率；功能
      【中图分类号】 R687.4 【文献标识码】 A 【文章编号】 1003—6350（2017）18—2969—05

Effect of patellar replacement on the prognosis and survival rate of patients with osteoarthritis in kneereplacement.
WANG Da-cheng, WU Hong-bo, GUO Han-ming. Department of Joint Surgery, Huizhou Central People'sHospital, Huizhou 516001, Guangdong, CHINA
【Abstract】 Objective To investigate the effect of patellar replacement on the prognosis and survival rate of pa-tients with osteoarthritis in knee arthroplasty. Methods The clinical data of 120 cases of knee osteoarthritis patients(120 knees) who admitted to our hospital from January 2012 to April 2014 were retrospectively analyzed, including 60cases of intraoperative replacement of the patella (the observation group) and 60 cases of no replacement of the patella(the control group). The patients were followed up for 2 years, and the knee function of the two groups was evaluated byKnee Society knee score (KSS) and functional score, patella score (PS) and pain visual analogue scale (VAS), and thesurvival rates of the two groups were compared by using survival curves. Results The KSS knee score, KSS functionscore and PS score of the two groups after 6 weeks, 3 months, 6 months and 1 year were significantly higher than thosebefore the operation. However, the VAS score was significantly lower than that of the two groups (P<0.05). The KSS·论 著·doi:10.3969/j.issn.1003-6350.2017.18.013基金项目：广东省惠州市科技计划项目(编号：2011Y024)