Xu Hu, Ding Ming, Wang Yingchun, Liao Binghui, Shangguan Lei
Institution of Orthopaedics, Xijing Hospital, Xi'an, China.
Arthrosc Tech. 2020 Sep 25;9(10):e1475-e1484. doi: 10.1016/j.eats.2020.06.009. eCollection 2020 Oct.
More than 100 surgical procedures have been reported to address recurrent patellar instability. Trochlear dysplasia is the most common finding among the anatomic risk factors for recurrent patellar instability. Various studies have shown that trochleoplasty combined with medial patellofemoral ligament reconstruction is an effective technique to treat recurrent patellar instability. Nevertheless, trochleoplasty is still a daunting procedure for surgeons because of its multiple and gloomy complications. This article introduces a technique to treat recurrent patellar instability with severe trochlear dysplasia: precise arthroscopic mini-trochleoplasty (PAM trochleoplasty) combined with medial patellofemoral ligament reconstruction. This technique precisely removes the supratrochlear spur and trochlear bump, accurately reshapes the trochlear sulcus with minimal invasion and less osteotomy volume, and keeps the sulcus cartilage intact. The purpose of this technique is to develop trochleoplasty into a common and safe technique, which has good outcomes and low complications.
据报道，有100多种外科手术可用于治疗复发性髌骨不稳定。在复发性髌骨不稳定的解剖学危险因素中，滑车发育不良是最常见的发现。各种研究表明，滑车成形术联合髌股内侧韧带重建是治疗复发性髌骨不稳定的有效技术。然而，由于其多种且严重的并发症，滑车成形术对外科医生来说仍然是一项艰巨的手术。本文介绍一种治疗伴有严重滑车发育不良的复发性髌骨不稳定的技术：精准关节镜下微型滑车成形术（PAM滑车成形术）联合髌股内侧韧带重建。该技术精确去除滑车嵴和滑车隆起，以最小的侵入和更少的截骨量精确重塑滑车沟，并保持沟软骨完整。该技术的目的是将滑车成形术发展成为一种常见且安全的技术，具有良好的效果和低并发症。
