《Hermes™ 髌股关节置换术的设计、手术技术及十年随访结果》。
Design, operative technique and ten-year results of the Hermes™ patellofemoral arthroplasty.
出版信息
Int Orthop. 2014 Feb;38(2):437-42. doi: 10.1007/s00264-013-2158-0. Epub 2013 Nov 5.
PURPOSE
Recently, increased interest has developed for patellofemoral arthroplasty as treatment for isolated patellofemoral arthritis. However, there are very few reports of the experience with the modern generation of patellofemoral arthroplasties. The new patellofemoral arthroplasty Hermes design is described. The design and technique of insertion are detailed.
METHODS
The indications were isolated patellofemoral disease with advanced arthritic damage. Ten-year followup is available for treatment of 70 knees. Postoperative radiographs of patients were assessed for Oxford deterioration and maltracking of the patella. Tracking was categorised as follows: normal tracking, patellar subluxation, patellar dislocation.
RESULTS
There were no late complications attributable to the arthroplasty. Disease progression in the tibiofemoral joint occurred in five patients requiring revision in three of these patients. Persistent anterior knee pain was recorded in four knees. The long-term results using this new design were better than those in the literature that described earlier designs, especially concerning malalignment. Only four knees in four patients had slight lateral patellar subluxation.
CONCLUSIONS
This implant offers a reasonable alternative to total knee replacement in patients with isolated patellofemoral disease.
目的
最近，人们对髌股关节炎的治疗方法——髌股关节置换术产生了浓厚的兴趣。然而，关于现代髌股关节置换术的经验报告却很少。本文介绍了一种新型的髌股关节置换术——Hermes 设计。详细描述了该设计和插入技术。
方法
适应证为孤立性髌股疾病伴晚期关节炎性损伤。对 70 例膝关节进行了 10 年随访。对患者的术后 X 线片进行了 Oxford 恶化和髌股关节轨迹不良的评估。轨迹分为以下几类：正常轨迹、髌股半脱位、髌股脱位。
结果
无晚期并发症归因于关节置换术。5 例患者的胫股关节疾病进展，其中 3 例需要翻修。4 例患者出现持续性膝关节前痛。使用这种新设计的长期结果优于文献中描述的早期设计，尤其是在对线不良方面。只有 4 例患者的 4 个膝关节出现轻微的外侧髌股半脱位。
结论
对于孤立性髌股疾病患者，这种植入物是全膝关节置换术的一种合理替代方法。
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