摘要
目的研究全膝置换术后相同屈膝角度下矢状位髌骨和髌腱之间的角度变化,及其与术后活动度的关系。方法材料为2002年5月～2003年12月期间做了初次全膝置换的33个关节(30例),诊断包括29个膝骨关节炎、4个类风湿性关节炎,其中20个关节置换了髌骨。男5例,女25例;年龄平均67.3岁。术前和术后1年摄0°、45°、90°侧位X线片,记录术后1年的活动度,测量术前术后不同屈膝度下的髌骨纵轴和髌韧带的夹角,并进行分析。结果术后1年在屈膝90°时,髌骨与髌腱的角度较术前增大(P<0.01)。更换髌骨和保留髌骨组术后都发生了相似的角度变化(P<0.01)。术后屈膝90°的髌骨髌腱角和术后活动度呈负相关(r=-0.506,P=0.003)。结论全膝置换术后在屈膝活动时的髌骨髌腱角变化规律发生改变,与置换髌骨无关;术后屈膝90°时髌骨髌腱角的改变幅度与术后活动度限制有关。
Objective To study the change in the angle between patella and patellar tendon,and assess the correlation between the angle and the range of motion. Methods Thirty - three knees were treated with total knee arthroplasty in thirty patients （three of whom had a bilateral procedure） between May 2002 and December 2003 by one group of experienced surgeons. There were 5 males and 25 females. The average age was 67.3 years old. Diagnoses included osteoarthritis in 29 knees and rheumatoid arthritis in 4 knees, Patella resurfacing was performed in 20 knees. Lateral view radiographs were taken at 0, 45 and 90 degrees of flexion preoperatively and one year postoperatively. The range of motion one year after operation and the angle between patella and patellar tendon on the radiographs were measured and recorded. Results One year after operation, the angle between patella and patellar tendon increased when flexion was 90 degrees（P 〈 0.01）. The variety of the angle in two groups divided by patella resurfaced or not was similar. Both changes are significant（ P 〈 0.01 ）. The angle measured postoperatively at 90 degrees flexion had correlation with the range of motion postoperatively（ r = -0.506, P = 0,003）. Conclusion The curve of the variety in the angle between patella and patellar tendon is changed after total knee arthroplasty, which is not caused by the patella resurfacing. The angle between patella and patellar tendon measured at 90 degrees flexion postoperatively is correlated with the motion restriction postoperatively.
出处
《中国骨与关节损伤杂志》
2007年第2期89-91,共3页
Chinese Journal of Bone and Joint Injury
关键词
全膝置换
髌骨
髌腱
活动度
角度
Total knee arthroplasty
Patella
Patellar tendon
Range of motion
Angle
