Barlow David, Foong Keen S, Rhee Shin J, Sutcliffe William, Griffin Stuart J
Department of Orthopaedics, Ysbyty Gwynedd Hospital, North Wales, UK.
J Med Case Rep. 2011 Aug 3;5:347. doi: 10.1186/1752-1947-5-347.
Locked knee caused by inferior patellar dislocation is considered rare in elderly patients. It was originally thought that, in the osteoarthritic knee, osteophytes on the pole of the patella become entrapped in the inter-condylar notch, which is managed by performing closed reduction and immobilization in a knee splint for three to four weeks. We present an unusual case of a locked knee with an impaction fracture. To the best of our knowledge, there have been no previous reports of such impaction fractures managed with arthroscopy.
We present an unusual case of an 88-year-old Caucasian woman with moderate arthritis who had a locked knee caused by an impaction fracture of the patella into the lateral femoral condyle. In this case report, we describe the need for arthroscopic surgery to prevent relocking of the knee in these patients.
This case report emphasizes the need for careful assessment of locked knees in elderly patients. Impaction fractures should be considered in all rare cases of patellar dislocation, and we advocate arthroscopic assessment of the articular cartilage in these patients. This is an important consideration, as the population demographics change and such impaction fractures may become more common in patients with degeneration in the knees.
髌下脱位导致的膝关节交锁在老年患者中被认为较为罕见。最初认为，在骨关节炎性膝关节中，髌骨两极的骨赘会陷入髁间切迹，对此可通过闭合复位并使用膝关节夹板固定三到四周来处理。我们报告一例伴有嵌插骨折的膝关节交锁的罕见病例。据我们所知，此前尚无关于此类嵌插骨折采用关节镜治疗的报道。
我们报告一例罕见病例，一名88岁患有中度关节炎的白人女性，因髌骨向外侧股骨髁嵌插骨折导致膝关节交锁。在本病例报告中，我们描述了此类患者为防止膝关节再次交锁而进行关节镜手术的必要性。
本病例报告强调了对老年患者膝关节交锁进行仔细评估的必要性。在所有罕见的髌骨脱位病例中均应考虑嵌插骨折，我们主张对这些患者的关节软骨进行关节镜评估。随着人口统计学特征的变化，此类嵌插骨折在膝关节退变的患者中可能会变得更为常见，这是一个重要的考虑因素。
