Hozack W J, Rothman R H, Booth R E, Balderston R A
University of Miami School of Medicine, FL 33101.
Clin Orthop Relat Res. 1989 Apr(241):203-8.
Patellofemoral pain due to an unusual suprapatellar fibrous nodule developed in three patients after posterior stabilized total knee arthroplasty. Each patient had a "catch" or "clunk" associated with pain on extension of the knee. At revision, a prominent fibrous nodule was found at the junction of the proximal patellar pole and the quadriceps tendon. The pathogenesis of this proximal fibrous nodule may involve impingement of the anterosuperior edge of the intercondylar notch area of the femoral component into the proximal quadriceps tendon or may involve impingement of the patellar prosthesis itself on the quadriceps tendon. Roentgenographic examination revealed an abnormally proximal placement of the patellar prosthesis on the patella. Surgical removal of the fibrous nodule resolved the symptoms. Revision of the patellar prosthesis may be necessary.
三名患者在接受后稳定型全膝关节置换术后，因髌上纤维结节异常而出现髌股关节疼痛。每位患者在膝关节伸展时都伴有“卡顿”或“咯哒”声并伴有疼痛。翻修时，在髌骨近端极与股四头肌肌腱的交界处发现一个突出的纤维结节。这种近端纤维结节的发病机制可能涉及股骨部件髁间凹区域的前上缘撞击近端股四头肌肌腱，或者可能涉及髌骨假体本身对股四头肌肌腱的撞击。X线检查显示髌骨假体在髌骨上的位置异常靠近近端。手术切除纤维结节可缓解症状。可能需要对髌骨假体进行翻修。
