Harato Kengo, Kobayashi Shu, Udagawa Kazuhiko, Iwama Yu, Masumoto Ko, Enomoto Hiroyuki, Niki Yasuo
Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.
Masumoto Sports Clinic, Tokyo, Japan.
Arthrosc Tech. 2017 Oct 16;6(5):e1897-e1901. doi: 10.1016/j.eats.2017.07.015. eCollection 2017 Oct.
Although surgical treatment is the gold standard for chronic patellar tendon rupture, the technique of patellar tendon reconstruction is still difficult. Basically, good clinical results of surgical repair for acute patellar tendon rupture have been reported. However, the results of reconstructive surgery for chronic patellar tendon rupture are still inconsistent. Some surgical options have been previously reported. For example, surgeons need to choose between 1- and 2-stage reconstruction. Furthermore, contralateral bone-tendon-bone graft, ipsilateral semitendinosus tendon graft, Achilles tendon allograft, and an artificial ligament have been used to reconstruct the patellar tendon. Generally, surgeons are concerned about postoperative complications, including loss of knee flexion, quadriceps weakness, and wound problems. One of the key points to avoid these complications is to improve proximal patellar migration. The purpose of this article is to present an easy and safe technique to bring down the patellar height with polyethylene tape and to reconstruct the patellar tendon with an artificial ligament. Although it has limitations, the described technique can facilitate reconstruction of chronic patellar tendon rupture.
虽然手术治疗是慢性髌腱断裂的金标准，但髌腱重建技术仍然具有挑战性。基本上，急性髌腱断裂手术修复的良好临床效果已有报道。然而，慢性髌腱断裂重建手术的结果仍不一致。此前已报道了一些手术选择。例如，外科医生需要在一期和二期重建之间做出选择。此外，对侧骨-腱-骨移植、同侧半腱肌肌腱移植、跟腱同种异体移植和人工韧带已被用于重建髌腱。一般来说，外科医生担心术后并发症，包括膝关节屈曲受限、股四头肌无力和伤口问题。避免这些并发症的关键要点之一是改善髌骨近端移位。本文的目的是介绍一种使用聚乙烯带降低髌骨高度并用人造韧带重建髌腱的简单安全技术。尽管该技术有局限性，但所描述的技术可以促进慢性髌腱断裂的重建。
