Fukagawa Shingo, Matsuda Shuichi, Mizu-uchi Hideki, Miura Hiromasa, Okazaki Ken, Iwamoto Yukihide
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Knee Surg Sports Traumatol Arthrosc. 2011 Jan;19(1):99-104. doi: 10.1007/s00167-010-1164-7. Epub 2010 Jun 5.
Although the results of total knee arthroplasty continue to improve, problems related to the patellofemoral joint remain significant. This study examined the factors affecting patellar alignment after total knee arthroplasty and subsequent changes in 56 knees during a postoperative period of 5.3 years. None of the knees examined displayed any clinical complications of the patellofemoral joint; no revision surgeries were necessary, with acceptable patellar alignment on average. The patellar resection angle had a strong influence on patellar alignment. Thinning of the patellar remnant on the medial side can increase postoperative lateral tilt, which leads to a need for lateral retinacular release. Although the changes in patellar alignment were minimal, the tendency that postoperative varus alignment resulted in patellar lateral tilt was observed. As postoperative femorotibial misalignment can lead to patellofemoral problems after total knee arthroplasty, surgeons need to pay scrupulous attention to femorotibial alignment and proper patellar preparation to decrease patellofemoral complications.
尽管全膝关节置换术的效果持续改善，但与髌股关节相关的问题仍然很突出。本研究调查了全膝关节置换术后影响髌骨对线的因素以及56个膝关节在术后5.3年期间的后续变化。所检查的膝关节均未出现髌股关节的任何临床并发症；无需翻修手术，平均髌骨对线情况可接受。髌骨切除角度对髌骨对线有很大影响。髌骨内侧残余部分变薄会增加术后外侧倾斜，这导致需要进行外侧支持带松解。尽管髌骨对线的变化很小，但观察到术后内翻对线导致髌骨外侧倾斜的趋势。由于术后股胫关节对线不良可导致全膝关节置换术后出现髌股关节问题，外科医生需要格外注意股胫关节对线和适当的髌骨准备，以减少髌股关节并发症。
