Krüger T, Göbel F, Huschenbett A, Hein W
Universitätsklinik und Poliklinik für Orthopädie und Physikalische Medizin Martin-Luther-Universität Halle-Wittenberg, Germany.
Zentralbl Chir. 2002 Oct;127(10):900-4. doi: 10.1055/s-2002-35138.
A retrospective study was performed in 26 patients who underwent an operation for femoro-patellar pain due to a patellar chondromalacia with or without minor patellar dislocation/lateral pressure syndrome. The average age of the patients was 28.5 (15-39) years. 22 of the 26 patients revealed minor chondral damages of the stages 1 and 2 according to Outerbridge. In 12 patients ("lavage" group), an arthroscopic joint debridement only was carried out, while an additional open, lateral retinaculum release was made in 14 patients ("lateral release" group). The patella's distance of dislocation according to Hepp was reduced on an average of 3.0 (0-7) mm (p = 0.0019). The results of Bentley's score obtained during the follow-up interval on an average of 30.1 (9 to 60) months were almost identical for both groups. "Good" and "very good" results were achieved in the "lavage" group (83.3 %) and "lateral release" group (78.6 % of the patients). Lateral release should be used in cases of patellar decentration between 5 and 10 mm and adequate pain symptoms. The post-operative distance of dislocation should be less than 5 mm. Under such conditions and with minor chondral damage, a combined approach by using an arthroscopic joint debridement and open lateral release is promising to treat a patellar dislocation/lateral pressure syndrome.
对26例因髌骨软化症伴或不伴轻微髌骨脱位/外侧压迫综合征而接受股骨-髌骨关节疼痛手术的患者进行了一项回顾性研究。患者的平均年龄为28.5岁（15 - 39岁）。根据Outerbridge标准，26例患者中有22例显示1期和2期的轻微软骨损伤。12例患者（“灌洗”组）仅进行了关节镜下关节清创术，而14例患者（“外侧松解”组）还进行了额外的开放性外侧支持带松解术。根据Hepp标准，髌骨脱位距离平均减少了3.0（0 - 7）mm（p = 0.0019）。在平均30.1个月（9至60个月）的随访期间，两组获得的Bentley评分结果几乎相同。“灌洗”组（83.3%）和“外侧松解”组（78.6%的患者）均取得了“良好”和“非常好”的结果。对于髌骨半脱位5至10 mm且有足够疼痛症状的病例，应采用外侧松解术。术后脱位距离应小于5 mm。在这种情况下且软骨损伤轻微时，采用关节镜下关节清创术和开放性外侧松解术的联合方法有望治疗髌骨脱位/外侧压迫综合征。
