ABSTRACT
Objective To explore the effect of total knee replacement with preservation of the patellar fat pad on shorterm clinical outcomes.Methods Eighty two patients with end-stage osteoarthritis were treated by total knee arthroplasty in the Central Hospital of Zhumadian City from May 2012 to May 2016 were randomly divided into resection group and reservation group,with 41 patients in each group.Patients in the two groups were given total knee replacement after general anesthesia,the patients in the resection group underwent a complete resection of the patellar fat pad during exposure to the field,while the patellar fat pad was retained partly or completely during the operation in the preservation group.Patients in the two groups were followed up for one year.The knee function score,knee mobility and anterior knee pain score before operation and one year after surgery were evaluated.Patellar tendon shortening and incidence of anterior knee pain of patients in the two groups were analyzed at one year after surgery.Results There was no significant difference in the knee score,functional score,anterior knee pain score and knee mobility before operation between the two group (P ＞ 0.05).At one year after operation,the knee score,functional score and knee flexion degree were higher,while the anterior knee pain score and flexion contracture were lower than those before operation in the two groups (P ＜ 0.05).There was no significant difference in the knee score,functional score,knee flexion degree and flexion contracture at one year after operation between the two groups (P ＞ 0.05),but the anterior knee pain score in the preservation group at one year after operation was lower than that in the resection group (P ＜ 0.05).There was no significant difference in the length of patellar tendon at one week after operation between the two groups (P ＞ 0.05).The length of patellar tendon was longer and the length of patellar tendon shortening in the preservation group at one year after operation was lower than that in the resection group(P ＜0.05).The incidence of anterior knee pain at one year after operation in the resection group and the preservation group was 22.0％ (9/41) and 2.4％ (1/41),respectively.The incidence of anterior knee pain at one year after operation in the preservation group was lower than that in the resection group (x2 =7.29,P ＜0.01).Conclusion To remain the patellar fat pad in the total knee replacement can improve the condition of anterior knee pain and decrease the degree of patellar tendon shortening after operation.