López-Franco M, Murciano-Antón M A, Fernández-Aceñero M J, De Lucas-Villarrubia J C, López-Martín N, Gómez-Barrena E
Orthopaedic Surgery Department, Hospital Infanta Sofia, Madrid, Spain; Orthopaedic Surgery Department, Hospital Sur de Alcorcón, Madrid, Spain; IdiPaz-Hospital La Paz Institute for Health Research, Madrid, Spain.
Knee. 2013 Dec;20(6):476-81. doi: 10.1016/j.knee.2013.08.006. Epub 2013 Aug 23.
Knee osteoarthritis mainly affecting the lateral facet of the patella, especially in young patients, is a definite challenge to the surgeon. Our purpose was to investigate the long-term outcome of a simple operation such as the partial lateral facetectomy on middle-aged to elderly patients with predominant lateral patellofemoral osteoarthritis.
A retrospective, long-term study of 39 knees (28 females, mean aged at surgery 61yearsold) with a minimum follow-up of 10years was performed. Evaluations included preoperative and postoperative questionnaires, physical examinations, and radiographs.
The main outcomes included the initial anterior pain relief, with higher scores using the Knee Society Score (that improved in 84% of the knees), and the eventual failure of the technique, including percentage of patients that required secondary total knee replacement (30% of the knees).
Partial lateral facetectomy aiming to decrease the high pressure in the lateral facet of the patella confirmed frequent pain relief. This surgical procedure being minimally invasive, relatively simple, and effective in selected patients, is a valid early alternative to more complex operations and does not preclude further reconstructive surgery in case of disease progression.
膝关节骨关节炎主要影响髌骨外侧小平面,尤其是在年轻患者中,这对外科医生来说是一个明确的挑战。我们的目的是研究一种简单手术(如部分外侧小平面切除术)对以外侧髌股关节骨关节炎为主的中老年患者的长期疗效。
对39例膝关节(28例女性,手术时平均年龄61岁)进行了一项回顾性长期研究,随访时间至少10年。评估包括术前和术后问卷、体格检查及X线片。
主要结果包括最初的前侧疼痛缓解,使用膝关节协会评分时得分更高(84%的膝关节有所改善),以及该技术最终失败,包括需要二次全膝关节置换的患者百分比(30%的膝关节)。
旨在降低髌骨外侧小平面高压的部分外侧小平面切除术证实能经常缓解疼痛。该手术操作微创、相对简单,且对选定患者有效,是更复杂手术的一种有效的早期替代方法,并且在疾病进展时不排除进一步的重建手术。