Department of Orthopedics, University of Maryland, Baltimore, MD, USA.
Expert Rev Med Devices. 2010 Jan;7(1):51-66. doi: 10.1586/erd.09.53.
Patellofemoral arthroplasty has been utilized as a treatment for isolated patellofemoral arthritis for more than 30 years. However, the use of this procedure remains controversial, as many surgeons prefer to use total knee arthroplasty, even for isolated patellofemoral arthritis. While historically, the results with this procedure have been inconsistent, recent developments in prosthesis design and surgical indications have improved the outcomes of patellofemoral arthroplasty. Potential advantages of patellofemoral arthroplasty include a less invasive approach, less bone resection, less tissue destruction, shorter operative time, less blood loss, shorter rehabilitation, and more normal knee kinematics. However, proper indications and surgical technique are crucial in order to obtain optimal results. Some future modifications have the potential to further improve the outcomes of the procedure, although additional investigations are needed to further explore some of these aspects. This report will describe current knowledge regarding the indications and contraindications for patellofemoral arthroplasty, present the results and complications of this procedure, discuss alternative treatments for patellofemoral disease, and explore future directions for arthroplasty of the patellofemoral compartment.
髌股关节置换术已被用于治疗孤立性髌股关节炎超过 30 年。然而，该手术的应用仍然存在争议，因为许多外科医生更倾向于使用全膝关节置换术，即使是治疗孤立性髌股关节炎。虽然该手术的历史结果不一致，但最近在假体设计和手术适应证方面的进展改善了髌股关节置换术的结果。髌股关节置换术的潜在优势包括微创入路、较少的骨切除、较少的组织破坏、较短的手术时间、较少的失血、较短的康复时间以及更正常的膝关节运动学。然而，为了获得最佳结果，适当的适应证和手术技术至关重要。一些未来的改良有可能进一步改善该手术的结果，但需要进一步的研究来进一步探索其中的一些方面。本报告将描述目前关于髌股关节置换术适应证和禁忌证的知识，介绍该手术的结果和并发症，讨论髌股疾病的替代治疗方法，并探讨髌股关节置换术的未来方向。
