Orthopaedic Clinic, Department of Surgical Sciences (DISC), IRCCS San Martino IST, Genova, Italy.
Orthopaedic Clinic, Department of Surgical Sciences (DISC), IRCCS San Martino IST, Genova, Italy.
Arthroscopy. 2018 May;34(5):1550-1558. doi: 10.1016/j.arthro.2017.11.038. Epub 2018 Feb 15.
To report the results of arthroscopic lateral retinacular release without excision of the accessory fragment for treatment of symptomatic bipartite patella with a minimum 2-year follow-up.
We retrospectively reviewed all cases of symptomatic type III bipartite patella confirmed by radiographs, computed tomography, and magnetic resonance imaging and treated with arthroscopic lateral release from 2005 to 2015. Patients with history of knee fractures or surgery, concomitant meniscal or anterior cruciate ligament (ACL) procedures, and severe arthritic changes of the patellofemoral joint were excluded. Patients were assessed by Kujala score, visual analog scale (VAS), Tegner Activity Scale (TAS), and time to return to sporting activities.
Ten patients (11 knees) were clinically reassessed after 69.6 ± 33.3 (range: 25-132; 95% confidence interval [CI]: 47.29-91.99) months from surgery. There was a significant improvement in Kujala (P < .05) and VAS scores (P < .05), and no differences were found between pre- and postoperative TAS scores (P > .05). No complications occurred during the follow-up period. All patients returned to sport after 42.3 ± 11.3 (range: 30-60; 95% CI: 34.71-49.84) days after surgery.
The arthroscopic lateral retinacular release of a symptomatic type III bipartite patella without excision of the accessory fragment allowed early return to sporting activities, with excellent symptom relief. Patients had significantly improved mean Kujala and VAS scores without a decrease in the mean TAS scores.
Level IV, case series.
报告关节镜下外侧支持带松解术（不切除副骨块）治疗症状性 III 型二分髌骨的结果，随访时间至少 2 年。
我们回顾性分析了 2005 年至 2015 年期间，所有经 X 线、CT 和 MRI 证实的症状性 III 型二分髌骨患者的病例。排除膝关节骨折或手术史、伴半月板或前交叉韧带（ACL）手术、髌股关节严重关节炎改变的患者。采用 Kujala 评分、视觉模拟评分（VAS）、Tegner 活动量表（TAS）和恢复运动活动时间对患者进行评估。
术后 69.6 ± 33.3（范围：25-132；95%置信区间[CI]：47.29-91.99）个月时，10 例（11 膝）患者进行了临床随访。Kujala（P <.05）和 VAS 评分显著改善（P <.05），而 TAS 评分术前和术后无差异（P >.05）。随访期间无并发症发生。所有患者术后 42.3 ± 11.3（范围：30-60；95% CI：34.71-49.84）天即可重返运动。
关节镜下外侧支持带松解术（不切除副骨块）治疗症状性 III 型二分髌骨可早期恢复运动，症状缓解效果极佳。患者的 Kujala 和 VAS 评分均显著改善，而 TAS 评分无明显下降。
IV 级，病例系列研究。
