Bell Ryan, Jimenez Andrew E, Levy Benjamin J, Willson Robert, Arciero Robert A, Edgar Cory M
Department of Orthopaedic Surgery, University of Connecticut School of Medicine, Farmington, Connecticut, U.S.A.
Department of Orthopedic Surgery, Augusta University Medical Center, Augusta, Georgia, U.S.A.
Arthrosc Tech. 2020 Nov 20;9(11):e1731-e1736. doi: 10.1016/j.eats.2020.07.020. eCollection 2020 Nov.
Surgical treatment of patellofemoral instability and associated cartilaginous lesions can be technically challenging. Visualization of patellar tracking and underlying osteochondral lesions is paramount to operative success. To treat these conditions effectively, a comprehensive arthroscopic assessment of the patellofemoral joint as well as dynamic visualization of patella tracking must be achieved. Visualization of the patellofemoral joint-in particular, the articular cartilage of the patella and trochlea morphology-can be difficult when using traditional anteromedial or anterolateral portals and a 30° arthroscope lens. The technique described here uses an accessory superolateral portal and a 70° arthroscope to achieve significantly improved visualization of the patellofemoral articulation, in particular the chondral surfaces. This vantage point aids the surgeon in effectively evaluating patellar tracking, trochlea morphology, and importantly, osteochondral lesion location to help guide treatment algorithms in the patellofemoral joint.
髌股关节不稳及相关软骨损伤的手术治疗在技术上可能具有挑战性。髌骨轨迹及潜在骨软骨损伤的可视化对于手术成功至关重要。为有效治疗这些病症，必须对髌股关节进行全面的关节镜评估以及对髌骨轨迹进行动态可视化。当使用传统的前内侧或前外侧入路以及30°关节镜镜头时，髌股关节的可视化，特别是髌骨的关节软骨和滑车形态，可能会很困难。本文所述技术使用辅助的上外侧入路和70°关节镜，以显著改善髌股关节面，特别是软骨表面的可视化。这个有利位置有助于外科医生有效评估髌骨轨迹、滑车形态，重要的是，有助于确定骨软骨损伤的位置，以帮助指导髌股关节的治疗方案。
