Clinical Study On Total Knee Arthroplasty With And Without Patellar Replacement

Objective:To compare the clinical effects of total knee arthroplasty with and without patellar replacement retrospectively.In order to provide a reference for clinical practiceMethods:140 cases of patients were selected from our hospital between January 2014 to December 2015,who were underwent unilateral TKA with and without patella replacement. All the patients were divided into patella replacement group and non patella replacement group according to the patella replacement or not.There were 30 males and 40 females in the patella replacement group,the age ranging from 54 to 78 years(average 66.45±4.65 years),the duration ranging from 2 to 24 years(average 13.34±3.67years),the body mass index ranging from 24.3to 27.1 kg/㎡(average 25.41±2.12kg/㎡);There were 32 males and 38 females in the non patella replacement group,the age ranging from 56 to 80 years(average 67.22±4.77 years),the duration ranging from 2 to 25 years(average 14.03±3.55 years),the body mass index ranging from 24.5 to 26.8 kg/㎡(average 25.36±2.26kg/㎡). The patients of patella replacement group were underwent patella replacement therapy,The patients of non patella replacement group were reserved patella.To compare the effects of the two groups after postoperative.All patients were followed 2 years at least,Compare the knee society score of preoperative and 3 months, 6 months, 1 year, 2 years after operation in the two group respectively. Compare the knee society score(KSS) of preoperative and 3 months, 6 months, 1 year, 2 years after operation between the two group respectively. Compare the Feller score of preoperative and 3 months, 6 months, 1 year, 2 years after operation in the two group respectively. Compare the Feller score of preoperative and 3 months, 6 months, 1 year, 2 years after operation between the two group respectively. The incidence of knee pain were compared after the operation of 3 months, 6 months, 1 year, 2 years. Compare the operation time and blood loss of the two groups. Compare the valgus angle, Insall-Salvati ratio and patellar tilt of the two groups. The data were analyzed using SPSS 17.0 software. Significant statistical difference used(P<0.05).Result:All patients were followed 2 years at least.There were no case reoperation for any complications of all the patients.There were no difference of the sex,age, duration,and the body mass index between the two groups(P<0.05).The knee society score of 3 months, 6 months, 1 year,and 2 years after operation were higher than the preoperative both the two groups(P<0.05).There were no difference of the knee society score(KSS) of preoperative and 3 months, 6 months, 1 year, 2 years after operation between the two groups(P>0.05). The Feller score of 3 months, 6 months, 1 year,and 2 years after operation were higher than the preoperative both the two groups(P<0.05).There were no difference of the Feller score of preoperative and 3 months, 6 months, 1 year, 2 years after operation between the two groups(P>0.05).There were no difference of the incidence of knee pain between the two groups.The operation time was longer in patella replacement group than the non patella replacement group(P<0.05). There was no difference of the blood loss between the two groups(P>0.05).There were no difference of the valgus angle, Insall-Salvati ratio and patellar tilt of the two groups(P>0.05).Conclusions:1 During the total knee replacement whether replace the patella or not,the clinical result is satisfactory,and the knee function was no significant difference between the two groups.2 The function of the patella was better than preoperative whether replace the patella or not,but there was no significant difference between the two groups. Patella replacement do not reduce the incidence of knee pain, long-term effect need to be further observed.3 The refined surgical technique and proper prosthesis design will improve clinical effect.