初次全膝关节表面置换术后关节线抬高的探讨

目的 分析研究初次全膝关节表面置换术后并发髌骨低位的机制. 方法 回顾性研究我科自2003年7月至2010年7月收治的260例380个膝关节表面置换术患者的资料.把insall-salvati指数大于0.8和关节线抬高4 mm定义为有临床意义.按照HSS膝关节评分（以75分为标准）将患者分成2组,观察高分组和低分组术后低位髌骨发生的情况.对2组的评分进行比较. 结果 高分组352膝,未发现低位髌骨患者;低分组28膝,其中22膝关节线抬高平均（7.0±2.0）mm.HSS膝关节评分结果：低位髌骨组评分低于正常组（P＜0.05）. 结论 在初次全膝关节表面置换术中要最大程度地恢复原有的膝关节线位置,并加强早期的膝关节功能锻炼.

Analysis of patellar baja after primary total knee arthoplasty

Objective To investigate the reasons uly patella baja occurred after primary total knee arthoplasty(TKA). Methods We retrospectively studied 380 primary TKA knees of 260 cases.Insall-salvati index was indicated to measure the height of patella and the variation of the joint line.We recognized such an clinical positive sign as the value of insall-salvati index ＞0.8 and proximally transfering joint line ＞4 mm.In mean term of follow up,subjects was divided to two groups according to HSS.The two groups took 75 score as a sorting baseline to analyze the correlation of patellar baja with the insall-salvati index and the proximally transfering joint line. Results There is no evdence of patellar baja in group of high scores of 352 knees.22 knees occurred patellar baja in group of low scores of 28 knees which joint line elevated(7 ± 2.0)mm.Patella baja were correlated with insall-salvati's index and elevation of joint line. Conclusions Patella baja occurred after TKA is multifactorial.We keep the original joint line maximally during TKA and stont knee rehabilitation as soon as possible after TKA.