Dick W, Henche H R, Morscher E
Arch Orthop Unfallchir. 1975;81(1):65-76.
At least 16 cases of posttraumatic chondromalacia of the patella out of a total of 79 patients operated between 1968 and 1971 were diagnosed on the basis of a questionnaire and follow-up examination. The clinical findings and delineation of this complaint from femoro-patellar osteoarthritis are discussed. The diagnosis was confirmed by arthroscopy in 2 patients. The significance of cartilagenous damage due to direct contusion is pointed out. The mechanisms which result in a degradation of the cartilagenous layer in the weeks following the accident are mentioned. The therapeutic consequences for the treatment of fractures of the patella are as follows: One must aim at exact bony reduction. Macroscopically damaged parts of the cartilage should be removed. Indication to partial patellectomy should be on a broad basis. A long term treatment with salicylic acid or Chloroquin-both of which are said to prevent enzymatic degradation of cartilage-should be considered.
在1968年至1971年间接受手术的79例患者中,至少有16例创伤后髌骨软骨软化症是根据问卷调查和随访检查确诊的。本文讨论了该疾病的临床发现以及它与股骨-髌骨关节骨关节炎的鉴别。2例患者通过关节镜检查确诊。指出了直接挫伤导致软骨损伤的重要性。文中提到了事故发生后数周内导致软骨层退化的机制。髌骨骨折的治疗后果如下:必须力求实现精确的骨折复位。肉眼可见受损的软骨部分应予以切除。部分髌骨切除术的指征应放宽。应考虑长期使用水杨酸或氯喹进行治疗,据说这两种药物都能防止软骨的酶促降解。