Doolittle K H, Turner R H
Mount Carmel Medical Center, Columbus, Ohio.
Orthop Rev. 1988 Jul;17(7):696-702.
We reviewed 350 knee arthroplasties performed between 1977 and 1984 for patellar problems. Seventeen knees with four types of patellofemoral complications were found. The diagnosis in both the group of 350 and the study group of 17 knees was evenly distributed between rheumatoid arthritis and osteoarthritis. The complication rate was 4.9%. Follow-up ranged from one to nine years post-complication. Two knees had two different complications, providing a total of 19 complications with five loosenings, three fractures of the patella, one fracture of the patellar component, and ten subluxations or dislocations. Sixteen revision surgical procedures were performed on 11 knees. Six knees were managed nonoperatively. In the four knees with multiple surgeries, one of the complications was patellar subluxation or dislocation. Only one patient was dissatisfied with his result; however, this included both knees. Patellar complications continue to be recognized as a frequent cause of problems after total knee arthroplasty. We recommend nonoperative management of patellar fractures, revision of implant with loosening or component fracture, and careful selection of realignment procedures.
我们回顾了1977年至1984年间因髌股问题而进行的350例膝关节置换术。发现17例膝关节存在4种类型的髌股并发症。在350例患者组和17例膝关节的研究组中，类风湿关节炎和骨关节炎的诊断分布均匀。并发症发生率为4.9%。并发症发生后的随访时间为1至9年。2例膝关节出现了两种不同的并发症，共19种并发症，包括5例松动、3例髌骨骨折、1例髌骨关节部件骨折以及10例半脱位或脱位。对11例膝关节进行了16次翻修手术。6例膝关节采用非手术治疗。在接受多次手术的4例膝关节中，其中一种并发症是髌骨半脱位或脱位。只有1例患者对其结果不满意；然而，这包括了双侧膝关节。髌股并发症仍然被认为是全膝关节置换术后问题的常见原因。我们建议对髌骨骨折采用非手术治疗，对出现松动或部件骨折的植入物进行翻修，并谨慎选择重新排列手术。
