Baker C L, Hughston J C
Hughston Orthopaedic Clinic, Columbus, Georgia 31995.
J Bone Joint Surg Am. 1988 Dec;70(10):1489-94.
A Miyakawa patellectomy was done in seventeen patients (twenty knees) for either osteoarthritis or chondromalacia of the patella, or both, secondary to malfunction of the extensor mechanism. Patients who had had a patellar fracture were not included in the series. The Miyakawa patellectomy realigns the extensor mechanism, with the proper tension, and centers the functional pull of the quadriceps tendon and patellar ligament. A superficial strip of the quadriceps tendon is pulled distally to fill the void that was left by removal of the patella and to maintain proper length. The musculotendinous portions of the vastus lateralis and vastus medialis are advanced over this defect in the midline and are sutured to the quadriceps tendon. The average length of follow-up was 13.8 years (range, 3.6 to 31.7 years). Nineteen of the twenty knees had a good or excellent subjective result and eighteen had a good or excellent objective result. No subsequent surgical treatment was needed for problems that were caused by malfunction of the extensor mechanism of the knee.
对17例患者（20个膝关节）实施了宫川髌骨切除术，这些患者因伸肌机制功能障碍继发髌骨骨关节炎或髌骨软化症，或二者兼有。曾发生髌骨骨折的患者未纳入该系列研究。宫川髌骨切除术可使伸肌机制重新排列，保持适当张力，并使股四头肌腱和髌韧带的功能拉力居中。将股四头肌腱的浅层条带向远端牵拉，以填充因切除髌骨而留下的空隙，并保持适当长度。股外侧肌和股内侧肌的肌肌腱部分在中线处越过该缺损向前推进，并缝合至股四头肌腱。平均随访时间为13.8年（范围为3.6至31.7年）。20个膝关节中有19个主观结果为良好或优秀，18个客观结果为良好或优秀。因膝关节伸肌机制功能障碍引起的问题无需后续手术治疗。
