Kanna Raj, Barrett David S
Department of Trauma and Orthopaedic Surgery, Southampton General Hospital, Southampton SO 16 6YD, UK.
J Clin Orthop Trauma. 2016 Jan-Mar;7(1):40-4. doi: 10.1016/j.jcot.2015.09.004. Epub 2015 Oct 23.
We present the case of a 50-year-old woman, who is a bilateral Syme's amputee and subsequently underwent patellofemoral arthroplasty (PFA) for osteoarthritis primarily involving the patellofemoral (PF) joint. History and physical examination were suggestive of severe PF arthritis without patellar instability of the right knee. The diagnosis was confirmed by roentgenogram and a PFA was performed. A slightly modified rehabilitation program was implemented and the patient was followed until 6 years after surgery. In comparison to the preoperative scores, the Oxford, the Western Ontario and McMaster Universities (WOMAC), the Knee Society, and the Hospital for Special Surgery Knee Scores improved significantly (p < 0.05) at the time of final follow-up. PF problems specific to below-knee amputees, factors to be considered before performing PFA, and the drawbacks of other treatment modalities in these patients have been discussed.
我们报告了一例50岁女性患者的病例，该患者为双侧Syme截肢者，随后因主要累及髌股（PF）关节的骨关节炎接受了髌股关节置换术（PFA）。病史和体格检查提示右膝存在严重的PF关节炎但无髌骨不稳定。通过X线片确诊后进行了PFA。实施了略有修改的康复计划，并对患者进行随访直至术后6年。与术前评分相比，末次随访时牛津、西安大略和麦克马斯特大学（WOMAC）、膝关节协会以及特种外科医院膝关节评分均有显著改善（p<0.05）。文中讨论了膝下截肢者特有的PF问题、进行PFA之前需考虑的因素以及这些患者其他治疗方式的缺点。
