Metcalfe A J, Clark D A, Kemp M A, Eldridge J D
Warwick Medical School, University of Warwick, University Hospitals of Coventry and Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX, UK.
Avon Orthopaedic Centre, Bristol, UK.
Bone Joint J. 2017 Mar;99-B(3):344-350. doi: 10.1302/0301-620X.99B3.37884.
The Bereiter trochleoplasty has been used in our unit for 12 years to manage recurrent patellar instability in patients with severe trochlea dysplasia. The aim of this study was to document the outcome of a large consecutive cohort of patients who have undergone this operation.
Between June 2002 and August 2013, 214 consecutive trochleoplasties were carried out in 185 patients. There were 133 women and 52 men with a mean age of 21.3 years (14 to 38). All patients were offered yearly clinical and radiological follow-up. They completed the following patient reported outcome scores (PROMs): International Knee Documentation Committee subjective scale, the Kujala score, the Western Ontario and McMaster Universities Arthritis Index score and the short-form (SF)-12.
Outcomes were available for 199 trochleoplasties in 173 patients giving a 93% follow-up rate at a mean of 4.43 years (1 to 12). There were no infections or deep vein thromboses. In total, 16 patients reported further patella dislocation, giving an 8.3% rate of recurrence. There were 27 re-operations, giving a rate of re-operation of 14%. Overall, 88% were satisfied with the operation and 90% felt that their symptoms had been improved.
All PROMs improved significantly post-operatively except for the mental component score of the SF-12. Trochleoplasty performed using a flexible osteochondral flap is an effective treatment for recurrent patellar instability in patients with severe trochlea dysplasia and gives good results in the medium term. Cite this article: 2017;99-B:344-50.
在我们科室，贝赖特滑车成形术已用于治疗严重滑车发育不良患者的复发性髌骨不稳长达12年。本研究的目的是记录一大组连续接受该手术患者的治疗结果。
2002年6月至2013年8月期间，对185例患者连续实施了214例滑车成形术。其中女性133例，男性52例，平均年龄21.3岁（14至38岁）。所有患者均接受每年一次的临床和影像学随访。他们完成了以下患者报告结局评分（PROMs）：国际膝关节文献委员会主观量表、库贾拉评分、西安大略和麦克马斯特大学关节炎指数评分以及简短健康调查（SF）-12。
173例患者中199例滑车成形术有治疗结果，平均随访4.43年（1至12年），随访率为93%。无感染或深静脉血栓形成。共有16例患者报告髌骨再次脱位，复发率为8.3%。有27例再次手术，再次手术率为14%。总体而言，88%的患者对手术满意，90%的患者感觉症状有所改善。
除SF-12的精神健康分量表外，所有PROMs术后均有显著改善。使用灵活的骨软骨瓣进行滑车成形术是治疗严重滑车发育不良患者复发性髌骨不稳的有效方法，中期效果良好。引用本文：2017；99-B：344-50。
