阿里·克罗吉乌斯（Ali Krogius）术式治疗髌股关节不稳定，即使是在骨骼未成熟的患者中，也应视为过时的方法。

The Ali Krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patients.

机构信息

Department of Orthopedics, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.

Department of Diagnostic and interventional Radiology, Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany.

出版信息

BMC Musculoskelet Disord. 2022 Mar 16;23(1):257. doi: 10.1186/s12891-022-05200-4.

DOI:10.1186/s12891-022-05200-4

PMID:35296292

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8925174/

Abstract

BACKGROUND

Several interventions are established for treating patellofemoral instability in adults. Fewer exist for pediatric patients without damaging the epiphysis. The Ali Krogius (AK) method is currently still being used. Most studies are not current and report varying results in small patient population. The aim of this study is to determine the long-term results of the AK method.

METHODS

In this monocentric, retrospective study design, 33 knees in 33 patients who received the AK procedure for recurrent patellar dislocation were assessed. The average age was 20.8 years (range 6-40). The following functional scores were assessed: Kujala Score, Lysholm Score and Tegner Score. Subgroup analysis was done for patients ≤16 years of age. Available preoperative imaging was assessed for known risk factors.

RESULTS

After an average follow-up of 7.8 years (Range 59-145 months), a total of 8 (24%) knees suffered a redislocation postoperatively. Seven of the eight dislocations occurred in patients ≤ 16 years of age. One knee (3%) was revised due to persistent pain. The median score was 86 points for the Kujala score and 90 for the Lysholm score. The median in the Tegner score was level 6. Clinically, the patellar glide was lateralized in 7 knees (21%) and an apprehension sign was triggered in 8 knees (24%).

CONCLUSIONS

Including the present study, the existing literature indicates a redislocation rate between 24 and 41% following AK. It should thus be regarded as obsolete even though it protects the epiphysis. Surgical interventions such as medial patellofemoral ligament reconstruction with femoral drilling distal to the epiphysis should be preferred.

TRIAL REGISTRATION

Retrospectively registered: S-302/2016.

LEVEL OF EVIDENCE

III.

摘要

背景

有几种干预措施可用于治疗成人髌股关节不稳定，但对于儿童患者，由于会损伤骨骺，故可用的方法较少。目前仍在使用 Ali Krogius（AK）方法。大多数研究都不是最新的，且报告的小患者群体的结果各不相同。本研究旨在确定 AK 方法的长期结果。

方法

在这项单中心回顾性研究设计中，对 33 名接受 AK 手术治疗复发性髌骨脱位的患者的 33 个膝关节进行评估。平均年龄为 20.8 岁（范围 6-40 岁）。评估以下功能评分：Kujala 评分、Lysholm 评分和 Tegner 评分。对≤16 岁的患者进行亚组分析。评估了可用的术前影像学检查以确定已知的危险因素。

结果

平均随访 7.8 年后（范围 59-145 个月），共有 8 例（24%）膝关节术后再脱位。8 例脱位中有 7 例发生在≤16 岁的患者中。1 例（3%）因持续疼痛而进行了翻修。Kujala 评分为 86 分，Lysholm 评分为 90 分，Tegner 评分为 6 级。膝关节髌骨滑动在 7 例（21%）中向外侧化，8 例（24%）触发了恐惧征。