Arvesen John E, Wyland Douglas J
Steadman Hawkins Clinic of the Carolinas, Prisma Health-Upstate, Greenville, South Carolina, U.S.A.
Arthrosc Tech. 2021 Jan 20;10(1):e67-e72. doi: 10.1016/j.eats.2020.09.009. eCollection 2021 Jan.
Patellofemoral arthritis that is due to patellofemoral instability or chronic patellofemoral maltracking can be a difficult treatment problem. Isolated patellofemoral arthroplasty (PFA) is a good option that preserves bone and can more accurately reproduce native kinematics when compared with total knee arthroplasty. Newer PFA designs have demonstrated improved survivorship, although survivorship has not shown equivalence with total knee replacement. It has been postulated that improving patellar tracking could potentially improve overall outcomes and survivorship for PFA. It follows then that optimizing patellar tracking in patients with patellofemoral malalignment by adding a tibial tubercle osteotomy to a PFA may improve the ultimate outcome of the procedure. The objective of this technical note is to describe our preferred method for the treatment of patients with chronic patellofemoral lateral tracking and end-stage arthritis.
由髌股关节不稳定或慢性髌股关节轨迹不良引起的髌股关节炎可能是一个难以治疗的问题。与全膝关节置换术相比，单纯髌股关节置换术（PFA）是一种保留骨质且能更准确重现自然运动学的良好选择。尽管PFA的生存率尚未显示出与全膝关节置换相当，但新型PFA设计已显示出生存率有所提高。据推测，改善髌骨轨迹可能会潜在地改善PFA的总体疗效和生存率。因此，通过在PFA中增加胫骨结节截骨术来优化髌股关节对线不良患者的髌骨轨迹，可能会改善该手术的最终效果。本技术说明的目的是描述我们治疗慢性髌股关节外侧轨迹不良和终末期关节炎患者的首选方法。
