Brockmeyer Matthias, Haupert Alexander, Kohn Dieter, Lorbach Olaf
Department of Orthopedic Surgery, Saarland University, Homburg/Saar, Germany.
Arthrosc Tech. 2016 Dec 12;5(6):e1419-e1424. doi: 10.1016/j.eats.2016.08.010. eCollection 2016 Dec.
Chronic patellar tendinosis (jumper's knee) is a common problem among athletes. Conservative treatment is successful in most of the cases including, among others, the use of nonsteroidal anti-inflammatory drugs, local cryotherapy, eccentric muscle training, limitation of sports activity, and local infiltration. In approximately 10% of conservatively treated patients, conservative treatment fails and surgery is required. Different open and arthroscopic surgical techniques have been described in the literature. The presented all-arthroscopic surgical technique for the treatment of chronic patellar tendinosis includes debridement of soft tissue at the lower patellar pole and resection of the bony lower patellar pole. It leads to excellent clinical results comparable to described open treatment and provides the benefits of a minimally invasive and safe procedure with a faster recovery and return to sporting activities after surgery. An additional bony resection in case of a prominent lower patellar pole does not lead to a significant extension of the operation time and may avoid a relapse or treatment failure in selective cases. Therefore, arthroscopic treatment such as the presented technique may be the preferred method for surgical treatment of chronic patellar tendinosis.
慢性髌腱炎(跳跃膝)是运动员中常见的问题。在大多数情况下,保守治疗是成功的,包括使用非甾体类抗炎药、局部冷冻疗法、离心肌肉训练、限制体育活动以及局部注射。在大约10%接受保守治疗的患者中,保守治疗失败,需要进行手术。文献中描述了不同的开放手术和关节镜手术技术。本文介绍的用于治疗慢性髌腱炎的全关节镜手术技术包括清理髌腱下极的软组织和切除髌腱下极的骨质。它能带来与所述开放治疗相当的优异临床效果,并具有微创、安全的手术优势,术后恢复更快,能更快重返体育活动。在髌腱下极突出的情况下进行额外的骨质切除不会显著延长手术时间,并且在某些选择性病例中可以避免复发或治疗失败。因此,像本文介绍的这种关节镜治疗可能是慢性髌腱炎手术治疗的首选方法。