[Long-term effectiveness of different patellar treatments in primary total knee arthroplasty].

To compare the long-term effectiveness of patellar denervation by electrotomy combined with patellar replacement and patellar denervation by electrotomy alone in primary total knee arthroplasty (TKA).A retrospective analysis was conducted on the clinical data of 30 patients treated with primary TKA of both knees between July 2013 and March 2015 who met the selection criteria. There were 11 males and 19 females, aged 56-79 years, with an average age of 67.6 years. One knee was randomly selected for patellar denervation by electrotomy combined with patellar replacement during TKA (combined group), while the other knee was treated with patellar denervation by electrotomy alone (control group). All patients adopted the same type of total knee prosthesis. After surgery, the patients were followed up regularly, and the occurrence of complications was recorded. The functions of the knee and patella were evaluated using the Knee Society Score (KSS) and Feller score, respectively. The position of the prosthesis, patella trajectory, and prosthesis loosening and wear were observed by imaging examination.All 30 patients were followed up 81.4-103.5 months, with an average of 90.4 months. The patellar thickness of the combined group ranged from 21 to 26 mm, with an average of 23.0 mm. The position of the prosthesis and patella trajectory in the combined group and the control group were good, without obvious loosening or wear. After operation, 2 sides (6.7%) in the combined group and 3 sides (10.0%) in the control group presented joint adhesion and poor activities. No complication such as lower limb deep vein thrombosis, aseptic fractures, and infections around the prosthesis occurred in both groups. At last follow-up, the KSS clinical score, KSS function score, and Feller score showed no significant difference between the two groups ( P>0.05). According to the KSS score, 24 patients (80.0%) had no obvious preference for patellar denervation combined with patellar replacement, 3 patients (10.0%) preferred patellar replacement combined with patellar denervation, and 3 patients (10.0%) preferred no patellar replacement. Anterior knee pain occurred in 6 sides (20.0%) of both groups.There is no significant difference in the long-term effectiveness between patellar denervation combined with patellar replacement and patellar denervation alone conducted in patients with knee osteoarthritis undergoing primary TKA.比较初次人工全膝关节置换术（total knee arthroplasty，TKA）中行髌骨去神经电切术联合髌骨置换术与仅行髌骨去神经电切术的远期疗效。.回顾分析2013年7月—2015年3月收治且符合选择标准的30例双膝初次TKA的晚期骨关节炎患者临床资料。男11例，女19例；年龄56～79岁，平均67.6岁。随机选取一侧膝关节于TKA术中行髌骨去神经电切术及髌骨置换术（联合组），对侧膝关节仅行髌骨去神经电切术（对照组）。所有患者均使用相同型号全膝关节假体。术后定期随访，记录并发症发生情况，采用美国膝关节协会评分（KSS）和Feller评分分别评估膝关节功能和髌骨功能；行影像学检查观察假体位置、髌骨轨迹以及假体有无松动、磨损等情况。.术后30例患者均获随访，随访时间81.4～103.5个月，平均90.4个月。联合组患者置换后髌骨厚度为21～26 mm，平均23.0 mm。联合组和对照组假体位置及髌骨轨迹均良好，假体无明显松动、磨损表现。术后联合组2侧（6.7%）、对照组3侧（10.0%）出现关节粘连活动不佳，两组均无下肢深静脉血栓形成、假体周围无菌性骨折、感染等并发症发生。末次随访时，两组KSS临床评分、KSS功能评分以及Feller评分比较差异均无统计学意义（ P>0.05）。根据术后KSS评分分析显示，24例（80.0%）对髌骨去神经电切术是否联合行髌骨置换术无明显偏好，3例（10.0%）倾向于联合行髌骨置换术治疗，3例（10.0%）倾向于不联合行髌骨置换术治疗。两组均有6侧（20.0%）发生膝前痛。.膝关节骨关节炎患者在初次TKA术中行髌骨去神经电切术联合髌骨置换术与仅行髌骨去神经电切术的远期疗效无明显差异。.