Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences, Toronto, Canada.
Knee. 2020 Dec;27(6):1821-1832. doi: 10.1016/j.knee.2020.09.018. Epub 2020 Nov 13.
Patella dislocation after primary or revision total knee arthroplasty (TKA) is a major challenge in revision surgery. In practice, the main reason for patella maltracking and instability following TKA is malrotation of the femoral and/or tibial components. A number of soft tissue procedures, once component malrotation is corrected, have been described including proximal realignment, quadricepsplasty and distal realignment of patellar tendon with tibial tubercle osteotomy. Here, we describe our modified surgical technique in managing chronically dislocated patellae in knee arthroplasty which comprises of extensive lateral releases, vastus medialis obliquus (VMO) advancement and soft tissue reconstruction of the extensor mechanism with accompanying three case presentations achieving satisfactory clinical outcomes.
初次全膝关节置换术或翻修全膝关节置换术后髌骨脱位是翻修手术中的一大挑战。在实践中，TKA 后髌骨轨迹不良和不稳定的主要原因是股骨和/或胫骨组件的旋转不良。一旦纠正了组件的旋转不良，就已经描述了许多软组织手术，包括近端重新排列、股四头肌成形术和髌腱的远端重新排列与胫骨结节截骨术。在这里，我们描述了我们在膝关节置换术中治疗慢性脱位髌骨的改良手术技术，该技术包括广泛的外侧松解、股直肌内侧斜肌（VMO）推进以及伸肌机制的软组织重建，同时伴有 3 个病例报告，均取得了满意的临床效果。
