Objective To study the influence of patellar resurfacing and gender on the curative effect of total knee arthroplasty (TKA) .Methods A retrospective study was carried on the clinical effects for 90 patients (90 knees ,aged 40-87 years old with an average of 66 .1 years ) with severe osteoarthritis treated by TKA .Among them ,29 cases were in the patella resurfacing group and 61 cases were the non-patella resurfacing group ,17 cases were male and 63 cases were female .Results Follow up lasted for 2-7 years (average 3 .3 years).The preoperative mean HSS scores were (58 .7 ±13 .2) points in the patella resurfacing group and (62 .4±14 .9 ) points in the non-patella resurfacing group ,(58 .8±10 .4) points in the male group and (56 .3±14 .8) points in the female group .The postoperative mean HSS scores were (90.6±5.7) points in the patella resurfacing group and (90.9±5.6) points in the non-patella resurfacing group ,(89 .2±5 .1) points in the male group and (91.2±6 .0) points in the female group .The HSS scores alter operation in each, group was significantly improved, than before operation . The difference oi postoperative HSS scores between the patella resurfacing group and non-patella resurfacing group had no statistical significance (P>0 .05) .The difference of postoperative HSS scores between the male group and the female group also had no statistical significance .The preoperative mean Feller patella scores were (13.3±3.1) points in the patella resurfacing group and (12 .2±4 .5) points in the non-patella resurfacing group ,the postoperative mean Feller patella scores were (26 .9±8 .2) points in the patella resurfacing group and (25 .0± 3 .1) points in the non-patella resurfacing group .The Feller patella scores after operation in both two groups were significantly im -proved .The difference of postoperative Feller patella scores between the two groups had no statistical significance (P>0 .05) .Conclusion The patients with knee osteoarthritis can gain good clinical effect after TKA .The early and midterm follow up results indicate that patella resurfacing and gender have no obvious influence on the clinical effect of TKA .%目的 回顾性分析全膝关节表面置换术(TKA)中髌骨置换与否和性别因素对其临床疗效的影响.方法 回顾性分析90例单侧TKA患者的临床疗效,年龄40～87岁,平均66.1岁,其中,髌骨置换29例(髌骨置换组),髌骨未置换61例(髌骨未置换组),男性17例(男性组),女性73例(女性组).结果 随访2～7年,平均3.3年.术前美国特种外科医院(HSS)膝关节评分髌骨置换组(58.7±13.2)分,髌骨未置换组(62.4±14.9)分,男性组(58.8±10.4)分,女性组(56.3±14.8)分,术后HSS评分髌骨置换组(90.6±5.7)分,髌骨未置换组(90.9±5.6)分,男性组(89.2±5.1)分,女性组(91.2±6.0)分;所有患者术后的HSS评分较术前均有明显改善,髌骨置换组和髌骨未置换组的术后HSS评分比较,差异无统计学意义(P>0.05),男性组和女性组的术后HSS评分比较,差异无统计学意义(P>0.05).Feller髌骨评分髌骨置换组术前(13.3±3.1)分,术后(26.9±8.2)分,髌骨未置换组术前(12.2±4.5)分,术后(25.0±3.1)分.髌骨置换组和髌骨未置换组术后Feller髌骨评分较术前有明显改善,两组间的术后Feller髌骨评分差异无无统计学意义(P>0.05).结论 膝关节骨性关节炎行TKA术后能获得良好的临床疗效;早、中期随访结果表明髌骨置换和性别对疗效无明显影响.
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