Fujiwara Shuichi, Hiranaka Takafumi, Hida Yuichi, Matsuda Shigeru, Uemoto Harunobu
Department of Orthopedic Surgery, Takatsuki Hospital, Japan.
Department of Orthopedic Surgery, Takatsuki Hospital, Japan.
Int J Surg Case Rep. 2017;38:73-77. doi: 10.1016/j.ijscr.2017.07.012. Epub 2017 Jul 8.
Permanent dislocation of the patella (PDP) is a rare condition. In cases of PDP with tibiofemoral arthritis, total knee arthroplasty may be performed through a medial parapatellar approach with patellar realignment. In this article we present two cases of PDP with tibiofemoral osteoarthritis successfully treated via lateral approach TKA without any additional realignment procedure. We performed two total knee arthroplasties for PDP with lateral tibiofemoral arthritis through a lateral approach without any realignment procedure. Mobile bearing inserts were used to adjust rotational alignment. The patients showed improved functional outcomes (Japanese Orthopaedic Association Knee score and Oxford Knee Score), and improved range of motion. Three years postoperatively, the patellae remain stable without dislocation nor maltracking, maintaining a high functional score.
To treat permanent dislocation of the patella with lateral knee osteoarthritis, TKA through a lateral approach have potential to be a new treatment option to achieve both a good outcome and repositioning of the patella.
髌骨永久性脱位（PDP）是一种罕见病症。对于合并胫股关节炎的PDP病例，全膝关节置换术可通过内侧髌旁入路并进行髌骨重新排列来实施。在本文中，我们展示了两例合并胫股骨关节炎的PDP病例，通过外侧入路全膝关节置换术成功治疗，无需任何额外的重新排列手术。我们通过外侧入路对两例合并胫股外侧关节炎的PDP患者进行了全膝关节置换术，未进行任何重新排列手术。使用活动轴承垫片来调整旋转对线。患者的功能结果（日本骨科协会膝关节评分和牛津膝关节评分）得到改善，活动范围也有所改善。术后三年，髌骨保持稳定，无脱位或轨迹不良，功能评分较高。
对于合并膝关节外侧骨关节炎的髌骨永久性脱位，通过外侧入路进行全膝关节置换术有可能成为一种新的治疗选择，既能取得良好效果，又能使髌骨复位。
