全膝人工关节置换术中髌骨置换对股四头肌肌力的影响

目的 探讨髌骨置换后髌骨轨迹、髌骨厚度等对股四头肌力的影响,为指导人工膝关节置换术髌骨关节置换方法及术后膝关节功能的恢复提供理论依据.方法 收集退变性骨性关节炎行膝关节置换术患者100例134个膝关节,由同一组医生进行同种关节假体关节置换,根据患者术后髌股关节情况分为3组,采用CYBEX-6000型等速肌力测试系统测试股四头肌肌力,采用伸展滞缺角度评价伸肌肌力.结果 髌骨轨迹不良以及髌骨假体安装位置不当造成股四头肌肌力和耐力明显下降,髌骨轨迹不良组(61±24)、髌骨假体位置不良组(56±33)与髌股关节正常组(86±22)间差异有统计学意义(P＜0.01).结论 髌前疼痛等临床症状主要与髌骨轨迹不良相关,而单纯的股四头肌无力主要与置换后的髌骨厚度有关;研究髌股关节生物力学与髌骨置换技术,有利于提高全膝置换手术疗效.

Muscle strength analysis of patella resurfacing in total knee arthroplasty

OBJECTIVE: To investigate the influence of patella tracking and thickness for muscle strength after patellar resurfacing in total knee arthroplasty (TKA). METHODS: Quadriceps muscle strength of 100 cases 134 knees with osteoarthritis were analysed with isokinetic testing and extension lag after patellar resurfacing in TKA. Result was analyzed statistically through T test. RESULTS: Significant decreasing of quadriceps muscle strength and endurance were detected on mal-patellofemoral tracking (61 +/- 24, P <0.01) and improper position of patella prosthesis (56 +/- 33, P < 0.01). Anterior knee pain with patella resurfacing was mainly associated with mal-patellofemoral tracking. CONCLUSION: Asymptomatic weakness of quadriceps muscle was mainly associated with improper patella thickness.