髌骨成形术与传统膝关节置换术对膝关节骨性关节炎的疗效观察

目的比较髌骨成形术与传统膝关节置换术治疗膝关节骨性关节炎的临床效果。方法选择2011年7月～2012年12月于浙江省海宁市人民医院住院并行手术治疗的膝关节骨性关节炎患者109例，其中，行髌骨成形术48例（髌骨成形术组），行传统膝关节置换术61例（传统膝关节置换术组），记录其术前、术后1周及术后2个月的VAS评分和KSS评分。结果髌骨成形术组术前、术后1周及术后2个月的VAS评分分别为（7．12±1．91）、（5．65±1．30）、（4．11±1．69）分，KSS评分分别为（48．12±11.88）分、（53．34±7．34）分、（65．12＋5．37）分；传统膝关节置换术组术前、术后1周及术后2个月的VAS评分分别为（7．59±2．41）、（4．55±1．69）、（2．35±1．28）分，KSS评分分别为（30．25±10．95）、（66．55±10．37）、（78．01±13．12）分；传统膝关节置换术组术后1周及术后2个月的VAS评分均较髌骨成形术组低，KSS评分均较髌骨成形术组高，差异均有统计学意义（均P＜0．05）。结论对于治疗中晚期骨性关节炎，传统膝关节置换术较髌骨成形术效果更佳。

Clinical observation of patellar arthroplasty and traditional knee arthroplasty in the treatment of knee osteoarthritis

Objective To discuss the clinical effects of patellar arthroplasty and traditional knee arthroplasty in the treatment of knee osteoarthritis. Methods 109 patients with knee osteoarthritis underwent operative treatment in the People＇s Hospital of Haining City from July 2011 to December 2012 were selected. 48 cases were given patellar arthroplasty treatment （patellar arthroplasty group）, 61 cases were given traditional knee arthroplasty treatment （traditional knee arthroplasty group）. The VAS score and KSS score before operation, 1 week and 2 months after operation were recorded. Results The VAS scores before operation, 1 week and 2 months after operation in the patellar arthroplasty group were （7.12±1.91）, （5.65±1.30）, and （4.11±1.69） scores, while the KSS scores were （48.12±11.88）, （53.34±7.34）, （65.12±5.37） scores. The VAS scores before operation, 1 week and 2 months after operation in the traditional knee arthroplasty group were （7.59±2.41）, （4.55±1.69）, （2.35±1.28） scores, while the KSS scores were （30.25±10.95）, （66.55±10.37）, （78.01＋13.12） scores. 1 week and 2 months after operation, the VAS scores of patients in the traditional knee arthroplasty group were lower than those in the patellar arthroplasty group, while the KSS scores were higher than those of in the patellar arthroplasty group, the differences were statistically significant （P 〈0.05）. Conclusion The effect of patellar arthroplasty in the treatment of middle-late osteoarthritis is worse than traditional knee arthroplasty.