Hughston J C, Deese M
Hughston Orthopaedic Clinic, PC, Columbus, Georgia 31995.
Am J Sports Med. 1988 Jul-Aug;16(4):383-8. doi: 10.1177/036354658801600413.
We examined 54 patients (60 knees) referred to us because of their failure to improve, or because of a worsening of their preoperative symptoms, following an arthroscopic lateral retinacular release. Thirty knees developed medial subluxation of the patella postoperatively. This disabling condition is new to us. It is previously unreported as a complication of arthroscopic lateral retinacular release. Anterior knee pain was the only reported preoperative symptom in 14 knees. Sixteen knees had a preoperative diagnosis of lateral patellar subluxation on the basis of a positive apprehension sign only. Eighteen of 30 knees had no surgery of the extensor mechanism other than the arthroscopic lateral release. The remainder additionally underwent varying types and numbers of operations in an attempt to resolve their disability. CAT scan evaluation of three patients who volunteered for the procedure demonstrated severe atrophy and retraction of the vastus lateralis. Loss of this dynamic lateral stabilizer contributed to the medial subluxation of the patella.
我们检查了54例患者（60个膝关节），这些患者因关节镜下外侧支持带松解术后症状未改善或术前症状加重前来就诊。30个膝关节术后出现髌骨内侧半脱位。这种致残情况对我们来说是新出现的。此前未报道其为关节镜下外侧支持带松解的并发症。14个膝关节术前唯一报告的症状是膝前疼痛。16个膝关节仅根据阳性恐惧试验术前诊断为髌骨外侧半脱位。30个膝关节中有18个除关节镜下外侧松解外未对伸膝装置进行其他手术。其余患者为试图解决其残疾问题还接受了不同类型和数量的手术。对3名自愿接受该检查的患者进行的CAT扫描评估显示股外侧肌严重萎缩和回缩。这种动态外侧稳定器的缺失导致了髌骨内侧半脱位。
