Imhoff A, Böni T
Orthopädische Universitätsklinik Balgrist, Zürich.
Z Orthop Ihre Grenzgeb. 1989 Mar-Apr;127(2):139-51. doi: 10.1055/s-2008-1040102.
Long term results in conservative and operative treatment (10-20 years) and their therapeutical consequences. There are many factors involved in the aetiology and pathogenesis of the patellofemoral pain syndrome. Increased pressure over the lateral facet with or without reduced pressure over the medial of the patella resulting from lateral positioning of the patella and different anatomical variants not of the patella, but of the condyles must be considered as well functional variants in the muscular and ligamentous system. Overviewing the literature we compare the long term results of operative versus conservative treatment. 75 patients, treated by the method of Maquet-Roux, and 150 patients, treated conservatively, showed satisfactory results in 72%, a Lysholm Score of 90.8 in the "Maquet"-group, but 89.9 points in the "conservative"-group with a follow-up of 23 years. In the "conservative"-group 52% had no signs of arthrosis, in the "Maquet"-group there are only 30% without signs of arthrosis. The X-ray examination had mostly shown a further stage of arthrosis not only in the femoropatellar, but also in the femorotibial compartment, especially in the "Maquet"-group.
保守治疗与手术治疗的长期结果(10 - 20年)及其治疗后果。髌股疼痛综合征的病因和发病机制涉及许多因素。髌骨外侧位置以及髁突而非髌骨的不同解剖变异导致髌骨外侧小面压力增加,伴或不伴有髌骨内侧压力降低,同时肌肉和韧带系统的功能变异也必须予以考虑。通过查阅文献,我们比较了手术治疗与保守治疗的长期结果。采用Maquet - Roux方法治疗的75例患者和保守治疗的150例患者,72%的结果令人满意,“Maquet”组的Lysholm评分为90.8分,而“保守”组为89.9分,随访23年。在“保守”组中,52%没有骨关节炎迹象,在“Maquet”组中只有30%没有骨关节炎迹象。X线检查大多显示不仅在髌股关节,而且在股胫关节间隙出现了更严重的骨关节炎阶段,尤其是在“Maquet”组。