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Synovium removal from the articular side of the quadriceps tendon around the superior pole of patella reduces the crepitus after total knee arthroplasty
International Orthopaedics ( IF 2.7 ) Pub Date : 2022-08-13 , DOI: 10.1007/s00264-022-05539-2
Sukanis Chumchuen 1 , Supakit Kanitnate 1 , Kittipong Wattanasirisombat 1 , Nattapol Tammachote 1
Affiliation  

Purpose

The purpose of this study was to investigate whether synovium removal from the articular side of the quadriceps tendon around the superior pole of the patella after total knee arthroplasty (TKA) reduced the incidence of patellar crepitus (PC) or not.

Methods

We retrospectively reviewed 134 consecutive patients who underwent primary posterior stabilized (PS)-TKA by one surgeon from 2010 to 2013. Sixty-seven patients performed without touching synovium at superior pole of patella and 67 patients performed with removing all synovium from superior pole of patella were compared; none had patellar resurfacing. Patients were followed up two and six weeks, three, six and 12 months and annually thereafter. The primary outcome was the incidence of PC, detected during follow-up, and was graded as absent (0), fine (1), or coarse (2).

Results

At one year of follow-up, the synovial removal (SR) group had a significant lower rate of PC compared to the synovial preserved (SP) group: 15/67 (22%) vs 34/67 (51%), adjusted odds ratio = 0.29, 95% confidence interval (CI) = 0.14 to 0.64, P = 0.002. All PC in SR group were grade 1 while four knees in SP group were grade 2. Mean PC onset was eight months after surgery (range 1.5 to 12, P = 0.78) in both groups.

Conclusion

Removal of the synovium from the articular side of the quadriceps tendon around the superior pole of patellar reduced the incidence of PC after primary PS-TKA without patellar resurfacing. This is a promising technique and might enlighten surgeons to reduce the noise and improve patient satisfaction after total knee replacement.



中文翻译:

从髌骨上极周围的股四头肌腱关节侧去除滑膜可减少全膝关节置换术后捻发音

目的

本研究的目的是调查在全膝关节置换术 (TKA) 后从髌骨上极周围的股四头肌腱关节侧切除​​滑膜是否会降低髌骨捻发音 (PC) 的发生率。

方法

我们回顾性回顾了 2010 年至 2013 年由一名外科医生接受原发性后稳定 (PS)-TKA 的 134 例连续患者。67 例患者在未触及髌骨上极滑膜的情况下进行手术,67 例患者从髌骨上极切除所有滑膜进行了比较;没有人进行髌骨表面置换。对患者进行 2 周和 6 周、3 个月、6 个月和 12 个月的随访,之后每年进行一次。主要结果是在随访期间检测到的 PC 发生率,并被分级为不存在 (0)、精细 (1) 或粗糙 (2)。

结果

在一年的随访中,与保留滑膜 (SP) 组相比,滑膜切除 (SR) 组的 PC 发生率显着降低:15/67 (22%) vs 34/67 (51%),调整后的几率比率 = 0.29,95% 置信区间 (CI) = 0.14 至 0.64,P  = 0.002。SR 组的所有 PC 均为 1 级,而 SP 组的 4 个膝关节为 2 级。两组的平均 PC 发病时间为术后 8 个月(范围 1.5 至 12,P  = 0.78)。

结论

从髌骨上极周围的股四头肌腱关节侧去除滑膜可降低原发性 PS-TKA 后 PC 的发生率,而无需进行髌骨表面置换。这是一项很有前途的技术,可能会启发外科医生在全膝关节置换术后减少噪音并提高患者满意度。

更新日期:2022-08-13
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