Nakase Junsuke, Oshima Takeshi, Takata Yasushi, Shimozaki Kengo, Asai Kazuki, Toyooka Kazu, Tsuchiya Hiroyuki
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
J Med Ultrason (2001). 2019 Oct;46(4):497-502. doi: 10.1007/s10396-019-00960-4. Epub 2019 Jul 1.
This study aimed to investigate the results of a new treatment procedure (ultrasound-guided injection and the "pie crust" technique for lengthening of capsular tendon structures) for symptomatic bipartite patella.
We retrospectively investigated patient outcomes following the treatment of symptomatic type III bipartite patella with our new technique. Fifteen knees in 14 boys (mean age, 13.0 ± 1.7 years) were included. The procedure involved the injection of 1% lidocaine (2 mL) and triamcinolone acetonide (5 mg) between the patella and fragment. We then punctured 10 sites from one skin puncture to extend lateral capsular tendon structures. The patients were clinically assessed using the Victorian Institute of Sports Assessment (VISA) score before and 1 week, 1 month, and 3 months after the procedure. Patients were also evaluated for complications.
The average VISA score was 45.7 ± 4.7 before treatment, 70.6 ± 7.3 at 1 week post-treatment, 84.4 ± 16.6 at 1 month post-treatment, and 88.6 ± 18.3 at 3 months post-treatment. The VISA score improvement from before the procedure to 1 week after the procedure was significant (P < 0.01). There were no complications in any of the patients, who returned to sports at a mean of 4.2 ± 2.1 weeks after the procedure. However, two patients (three knees) had poor results and could not return to action; thus, they underwent surgical treatment 4 months after the ultrasonographic procedure.
This novel method is a potential treatment option for the management of symptomatic bipartite patella in outpatient clinics.
本研究旨在探讨一种新的治疗方法（超声引导下注射及“皮瓣”技术延长髌股关节囊肌腱结构）治疗有症状的二分髌骨的效果。
我们回顾性研究了采用新技术治疗有症状的III型二分髌骨后的患者预后。纳入14名男孩（平均年龄13.0±1.7岁）的15个膝关节。该操作包括在髌骨和骨块之间注射1%利多卡因（2 mL）和曲安奈德（5 mg）。然后从一个皮肤穿刺点穿刺10个部位以延长外侧关节囊肌腱结构。在术前以及术后1周、1个月和3个月，使用维多利亚运动评估研究所（VISA）评分对患者进行临床评估。还对患者的并发症进行了评估。
治疗前平均VISA评分为45.7±4.7，治疗后1周为70.6±7.3，治疗后1个月为84.4±16.6，治疗后3个月为88.6±18.3。从术前到术后1周VISA评分的改善具有显著性（P<0.01）。所有患者均未出现并发症，术后平均4.2±2.1周恢复运动。然而，两名患者（三个膝关节）效果不佳，无法恢复运动；因此，在超声检查后4个月他们接受了手术治疗。
这种新方法是门诊治疗有症状二分髌骨的一种潜在治疗选择。
