髌周去神经化预防全膝关节置换术后膝前疼痛

目的　依据髌周解剖学特点，探讨全膝关节置换术（total knee arthroplasty，TKA）中应用髌周电灼去神经化的临床效果。 方法　纳入82名诊断为骨性关节炎的患者（91膝），予行双侧或单侧不置换髌骨的TKA，按随机对照原则将病人分为两组，共有41名实验组患者（45膝）在TKA中接受了髌周去神经化处理，41名对照组患者（46膝）未做该处理。手术主刀为同一骨科医师，均使用相同的膝关节假体系统。主要评价项目包括膝关节KSS评分、Western Ontario and McMaster Universities（WOMAC）、Feller髌骨评分及VAS评分。 结果　82名患者术后均获随访，平均随访时间为12个月，两组病人的膝关节KSS评分、WOMAC、Feller髌骨评分及VAS评分均无显著统计学差异（P>0.05）。 结论　在TKA中行髌周电灼去神经化，不能显著改善病人的预后。

Circumpatellar denervation prevents anterior knee pain after total knee arthroplasty

Objective　According to the anatomy around the patella, the clinical effect of peripatellar electrocautery denervation in total knee arthroplasty (TKA) was investigated.　Methods　Eighty-two patients diagnosed with osteoarthritis (91 knees) were included, and bilateral or unilateral TKA without patella replacement was performed. Patients were divided into two groups according to the method of randomized controlled trials. A total of 41 patients (45 knees) in the experimental group received peripatellar denervation during total knee replacement, while 41 patients in the control group (46 knees) did not receive this treatment. All surgical operations were performed by the same orthopaedic surgeon using the same knee prosthesis system. The main evaluation items included knee KSS score, Western Ontario and McMaster Universities (WOMAC score), Feller patella score and VAS score.　Results　All of the 82 patients were followed up postoperatively, the average follow-up time was 12 months. knee patella KSS score, WOMAC, Feller score and VAS score in the two groups of patients had no significant difference (P>0.05).　Conclusion　It is considered that circumpatellar denervation in TKA cannot significantly improve the prognosis of patients.