实用医学杂志 ›› 2021, Vol. 37 ›› Issue (22): 2898-2902.doi: 10.3969/j.issn.1006⁃5725.2021.22.014

• 临床研究 • 上一篇    下一篇

人工全膝关节置换术中髌下脂肪垫保留与否对患者术后的功能及伤口愈合影响

余江 冉学军 胡兆洋 覃勇志   

  1. 四川大学华西广安医院(广安市人民医院)骨科(四川广安 638000)

  • 出版日期:2021-11-25 发布日期:2021-11-25
  • 基金资助:
    广安市人民医院 2021 年度推动医院高质量发展基金项目(编号:2IFZ014)

Effect of preserved infrapatellar fat pad on postoperative function and wound healing in total knee arthro⁃ plasty

YU Jiang,RAN Xuejun,HU Zhaoyang,QIN Yongzhi.   

  1. Department of Orthopaedics,Guang′ an People′ s Hospital,Guang′an 638000,China

  • Online:2021-11-25 Published:2021-11-25

摘要:

目的 探讨人工全膝关节置换术中髌下脂肪垫(infrapatellar fat pad,IPFP)保留与否对患者 术后功能、伤口愈合的影响。方法 共收集150例因膝关节重度关节炎行手术治疗患者,随机分为 IPFP 除组和IPFP 保留组。随访时间为术后1、2、3、6、12个月,两组患者术前在性别、年龄、膝前痛、KSS 膝关 节功能评分、膝关节活动度方面差异无统计学意义。结果 150例患者纳入研究,两组手术时间差异无统 计学意义,两组伤口术后引流量差异无统计学意义,术后拔出引流管时间差异无统计学意义(P>0.05)。随 访结果显示在术后各时间点,KSS 膝关节功能评分两组差异无统计学意义。但 IPFP 切除组在术后早期膝 关节切口下方渗液 13%的发生率明显高于 IPFP 保留组的 6%(P<0.05)。术后 1、2、3 个月,IPFP 切除组膝 前疼痛明显高于 IPFP 保留组(P<0.05),术后 6、12 个月两组膝前疼痛差异无统计学意义。结论 人工全 膝关节置换术中切除髌下脂肪垫可以导致患者术后早期膝关节下段伤口渗液及术后早期膝前痛的发生 率增加;术中应尽量保留髌下脂肪垫,术中应重建髌下脂肪垫。

关键词:

膝关节, 关节置换术, 髌下脂肪垫, 膝前疼痛, 伤口愈合

Abstract:

Objective To explore the effect of preserved infrapatellar fat(IPFP)pad on the postoperative function and wound healing of patients undergoing artificial total knee arthroplasty. Methods A total of 150 patients with severe knee arthritis were randomly divided into IPFP resection group and IPFP preservation group. The follow up time was 1 month,2 months,3 months,6 months and 12 months after operation. There was no significant difference in gender,age,anterior knee pain,KSS knee function score and range of motion between the two groups before operation. Results All the 150 patients were included in the study. There was no difference between the two groups in the operation time,postoperative drainage volume and postoperative drainage time(P > 0.05). The follow.up results showed that there was no difference in the KSS knee function score between the two groups at each time point after operation. However,the incidence of subincisional exudation in the IPFP resection group was significantly higher than that in the IPFP preservation group(13% vs. 6%,P < 0.05). At 1,2 and 3 months after operation,the anterior knee pain level of the resection group was significantly higher than that of the preservation group(P < 0.05),but at the other two time points,there was no significant difference between the two groups. Conclusion The preservation of infrapatellar fat pad during total knee arthroplasty can increase the incidence of early postoperative wound exudation and early postoperative anterior knee pain. The infrapatellar fat pad should be preserved as much as possible or even reconstructed during the operation.

Key words:

knee, arthroplasty, IFPF, anterior knee pain, wound healing