Aglietti P, Pisaneschi A, De Biase P
I Clinica Ortopedica dell'Università, Firenze.
Ital J Orthop Traumatol. 1992;18(1):25-36. doi: 10.1007/BF02620424.
The authors compare three surgical techniques for treatment of recurrent dislocation of patella. The best results, even in the correction of lateral patellar displacement, were achieved with proximal realignment, while the worst results occurred when lateral retinacular release was used alone. In distal realignment, the degree of correction necessary must be ascertained by thorough preoperative assessment of both patellar height and malalignment between femoral groove and tibial tubercle. If the medial retinacular structures are weakened, it may be necessary to perform proximal realignment. We believe that a single surgical option is insufficient, and that the best solution for each individual case should be chosen according to precise indications. The choices include proximal realignment, distal realignment, or a combination of both, while lateral release should always be used in combination with another technique.
作者比较了三种治疗复发性髌骨脱位的手术技术。即使在纠正髌骨外侧移位方面，近端重新排列术取得了最佳效果，而单独使用外侧支持带松解术时效果最差。在远端重新排列术中，必须通过术前全面评估髌骨高度以及股骨髁间沟与胫骨结节之间的排列不齐情况，来确定所需的矫正程度。如果内侧支持带结构变弱，则可能有必要进行近端重新排列术。我们认为单一的手术选择是不够的，应根据精确的指征为每个病例选择最佳解决方案。选择包括近端重新排列术、远端重新排列术或两者结合，而外侧松解术应始终与另一种技术联合使用。
