Järvelä T, Paakkala T, Kannus P, Järvinen M
Department of Surgery, Tampere University Hospital and Medical School, University of Tampere, Finland.
Am J Sports Med. 2001 Jan-Feb;29(1):18-24. doi: 10.1177/03635465010290010701.
To evaluate the development of postoperative patellofemoral osteoarthritis, we performed a retrospective clinical and radiographic study of 100 patients who had undergone anterior cruciate ligament reconstruction with a bone-patellar tendon-bone autograft an average of 7 years before the follow-up. Radiographic evaluation showed no patellofemoral osteoarthritis in 53 patients (group I), mild osteoarthritis in 34 patients (group II), moderate osteoarthritis in 12 patients, and severe osteoarthritis in 1 patient (group III, moderate and severe changes). The average shortening of the patellar tendon was 2.4 mm in group I, 3.9 mm in group II, and 6.8 mm in group III. The placement of the femoral or tibial tunnel of the graft, as measured from lateral radiographs, did not correlate significantly with the degree of patellofemoral osteoarthritis. Patients who developed patellofemoral osteoarthritis experienced worse final outcomes, were more often dissatisfied with the condition of the operated knee, experienced more frequent pain and swelling in the knee joint, and had poorer range of motion and poorer quadriceps muscle strength than did patients without patellofemoral osteoarthritis. Only three patients had an unstable knee, and degenerative changes in the tibiofemoral joint were uncommon.
为评估术后髌股关节炎的发展情况，我们对100例患者进行了一项回顾性临床和影像学研究，这些患者平均在随访前7年接受了自体骨-髌腱-骨移植的前交叉韧带重建术。影像学评估显示，53例患者（I组）无髌股关节炎，34例患者（II组）有轻度骨关节炎，12例患者有中度骨关节炎，1例患者有重度骨关节炎（III组，中度和重度改变）。I组髌腱平均缩短2.4mm，II组为3.9mm，III组为6.8mm。根据侧位X线片测量，移植骨的股骨或胫骨隧道位置与髌股关节炎程度无显著相关性。发生髌股关节炎的患者最终结局更差，对手术膝关节状况的满意度更低，膝关节疼痛和肿胀更频繁，活动范围和股四头肌力量比未发生髌股关节炎的患者更差。只有3例患者膝关节不稳定，胫股关节的退行性改变不常见。
