Self-control Study Of With Or Without Resurfacing The Patella During Of Simultaneous Bilateral Total Knee Arthroplasty

Objective To compare the early effectiveness between patients undergo treatment of knee osteoarthritis(OA)with or without resurfacing the patella during of Simultaneous bilateral total knee arthroplasty(TKA).Methods A total of 40 patients(80 knees)undergoing bilateral TKA were selected from the Department of Orthopaedic Surgery,Affiliated Hospital of Qingdao University between February 2015 to December 2015.80 knees wer e randomly divided into two groups,the replacement group(40 knees with intraoperative patella replacement;21 cases on the left,19 knees on the right),and the control group(40 knees without intraoperative patella replacement;left knee 19,right knee 21).All patients were using the Advance internal axis total knee surface replacement system by Micro Port Company,and surgeries were completed by the same senior physician surgeon.The American Knee Society Score(KSS-clinical score;KSS-function score)?Patella Feller score?knee joint activity?anterior knee pain?range of motion?patient satisfaction and other indicators were observed and recorded.Preoperative and postoperative Radiographic examination of patellar tilt angle?patellar fit angle?patellar ligament ratio,etc.were performed.This is a double-blind randomized clinical trial.Results The clinical score and functional score of KSS in patella replacement group and non-replacement group were significantly higher than those before operation,and patients from both groups had good activity and knee function after operation.The Clinical score and KSS-function score of both groups show no significant different at 3 months? 6 months? 9 months and 12 months after the operation(P> 0.05).The KSS-function score of replacement group and control group at 9 months and 12 months after operation show significant differences,replacement group was higher than control group(P <0.05).The Patella Feller score of both groups at 6 months?9 months and 12 months after the operation show statistically significant,replacement group was higher than control group(P <0.05).The incidence of anterior knee pain of both groups at 6 months?9 months and 12 months after the operation show statistically significant,the control group was higher than that in the replacement group(P <0.05).There was no significant difference in the imaging indexes between the two groups(P> 0.05).The patella tilt angle and patellar angle both improved after the operation.There was no low grade patella found in both groups.The satisfactions of both groups at 12 months after the operation had statistically significant,replacement group was higher than control group(P<0.05).There were no statistical difference of total blood loss between two groups during the operation,however the operation time for replacement group was longer than control group(P <0.05).There were no patella fracture ? necrosis ? prosthesis loosening complications found in Patients from both groups.Conclusion Application of total knee arthroplasty in the treatment of knee osteoarthritis can significantly improve the patient's knee function.Replacement of the patella can improve patient's postoperative satisfaction and knee function scores,and reducing the incidence of postoperative anterior knee pain.There was no significant difference in intraoperative blood loss and imaging evaluation between two groups,but the operation time of the replacement group was higher than non-replacement group.