中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (13): 2421-2424.doi: 10.3969/j.issn.1673-8225.2011.13.033

• 骨与关节综述 bone and joint review • 上一篇    下一篇

人工全膝关节表面置换中髌骨的处理

张  欣，王志伟   

  1. 解放军第二军医大学长海医院骨科，上海市200433
  • 收稿日期:2010-11-05 修回日期:2011-03-09 出版日期:2011-03-26 发布日期:2013-10-23
  • 通讯作者: 王志伟，博士，副教授，解放军第二军医大学长海医院骨科，上海市 200433 shwangzhiwei@vip.sina.com
  • 作者简介:张欣★，男，硕士。 zhangxin_med@163.com

Patella treatment in total knee arthroplasty

Zhang Xin, Wang Zhi-wei   

  1. Department of Orthopedics, Changhai Hospital of Second Military Medical University of Chinese PLA, Shanghai  200433, China
  • Received:2010-11-05 Revised:2011-03-09 Online:2011-03-26 Published:2013-10-23
  • Contact: Wang Zhi-wei, Doctor, Associate professor, Department of Orthopedics, Changhai Hospital of Second Military Medical University of Chinese PLA, Shanghai 200433, China shwangzhiwei@vip. sina.com
  • About author:Zhang Xin★, Master, Department of Orthopedics, Changhai Hospital of Second Military Medical University of Chinese PLA, Shanghai 200433, China zhangxin_med@163.com

PDF

566

被引次数

9

摘要：

背景：随着临床工作与实验研究的深入开展，膝关节置换的技术与假体设计均得到了不断地改进，然而髌骨的处理方法一直是争论的焦点。
目的：分析髌骨常规置换、髌骨常规保留、髌骨选择性置换3种方法的各自特点及优缺点，寻求膝关节置换过程中髌骨处理的最佳方案。
方法：由第一作者于2010-01应用计算机检索PubMed数据库、万方数据库和维普数据库相关文献。英文资料的检索时间为1990/2010；中文资料的检索时间为1990/2010。英文检索词为“total knee arthroplasty；patellar；replacement”；中文检索词为“人工全膝关节表面置换；髌骨；处理；常规置换；常规保留；选择性置换”。 纳入标准：①人工全膝关节表面置换假体设计相关研究。②人工膝关节假体的生物相容性。③人工全膝关节表面置换时髌骨的处理方法。阅读标题和摘要进行筛选，共纳入32篇用于综述。
结果及结论：长期以来，国内外学者围绕是否应进行髌骨置换在随访研究中各持己见，观点不一，逐渐演化为髌骨常规置换、髌骨常规保留、髌骨选择性置换3种观点。目前人工全膝关节表面置换关于髌骨处理的问题仍需进一步长期的随访和随机对照研究，在对文献进行回顾分析、随机化对照研究时，应慎重把握文献的可信度、时间范围、评价标准，以更准确、合理地指导医生们的临床工作。

关键词: 人工全膝关节表面置换, 髌骨, 处理, 常规置换, 常规保留, 选择性置换

Abstract:

BACKGROUND: Total knee arthroplasty technique and prosthetic design have been improved with the development of clinical practice and experimental research, however, the treatment of patella is a bone of contention in total knee arthroplasty.
OBJECTIVE: To analyze the features of routine patellar resurfacing, routine patellar reservation and selective patellar resurfacing in order to provide preferred plan for patellar treatment in total knee arthroplasty.
METHODS: PubMed, Wanfang and VIP databases were searched by the first author with key words of “total knee arthroplasty, patellar, replacement” both in English and Chinese. Inclusive criteria: ①Papers regarding prosthetic design in total knee arthroplasty. ②Biocompatibility of total knee prosthesis. ③Patellar treatment in total knee arthroplasty. After reading titles and abstract, 32 manuscipts were included in this review.
RESULTS AND CONCLUSION: For a long time, scholars have different opinions on how to treat patella in total knee arthroplasty and form three main opinions, namely, routine patellar resurfacing, routine patellar reservation and selective patellar resurfacing. Currently, how to treat patella in total knee arthroplasty still need further long-term follow-up and randomized controlled studies. Based on retrospective analysis and randomized controlled studies, degree of confidence, time duration, and evaluating criteria should be considered to make reasonable decision to guide clinical application.

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