Ferrari Marcio B, Sanchez George, Chahla Jorge, Moatshe Gilbert, LaPrade Robert F
Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
The Steadman Clinic, Vail, Colorado, U.S.A.
Arthrosc Tech. 2017 Mar 20;6(2):e357-e362. doi: 10.1016/j.eats.2016.10.002. eCollection 2017 Apr.
Isolated patellofemoral osteoarthritis is relatively prevalent, with the lateral facet of the patella being the most commonly affected portion. This pathology can be a result of a patellar maltracking syndrome, patella instability, or idiopathic degenerative changes. A thorough diagnostic work-up with a physical examination and imaging studies are mandatory for a proper diagnosis and to rule out other causes of patellofemoral knee pain. These patients are often treated nonoperatively with exercises for patella mobility, intra-articular injections, braces, patellar tracking, quadriceps balance and strength, and activity modification. Patients with lateral patellar pain that is refractory to nonoperative management, and who have a clear bony deformity on the patella overriding the lateral aspect of the trochlea, can benefit from surgical intervention. We recommend an arthroscopic lateral patellar facetectomy because the joint can be dynamically assessed, treated, and re-evaluated intraoperatively to ensure that normal bony contact has been restored.
孤立性髌股关节炎相对常见，髌骨外侧小面是最常受累的部位。这种病理情况可能是髌股关节轨迹不良综合征、髌骨不稳定或特发性退行性改变所致。进行全面的诊断检查，包括体格检查和影像学检查，对于正确诊断和排除髌股关节疼痛的其他原因至关重要。这些患者通常采用非手术治疗，包括进行改善髌骨活动度的锻炼、关节内注射、支具治疗、髌股关节轨迹调整、股四头肌平衡与力量训练以及调整活动方式。对于非手术治疗无效且髌骨存在明显骨畸形并覆盖滑车外侧的外侧髌骨疼痛患者，手术干预可能有益。我们推荐关节镜下外侧髌骨小面切除术，因为术中可以动态评估、治疗和重新评估关节，以确保恢复正常的骨接触。
