Hernigou P, Goutallier D
Rev Chir Orthop Reparatrice Appar Mot. 1987;73(1):43-8.
The progressive radiological changes in the patello-femoral joint after upper tibial osteotomy performed for arthrosis of the knee were studied more than 10 years after the surgical procedure. The changes were found to be minimal. In cases where the patello femoral joint space was normal before the osteotomy, it was still so 10 years later. In half of the cases where the patello-femoral joint space was abnormal before the osteotomy, it had deteriorated 10 years later, the lesions being more severe on the medial facet of the patella. This change occurred in 11 cases. It was not affected by the extent of the valgus osteotomy, changes in the tibio femoral joint space or the technique of the osteotomy. The functional results could only be correlated with the changes in the tibio femoral joint space and not with those in the patello-femoral joint space. However, excellent results as regards the tibio femoral joint space could still be associated with pain in the patello-femoral joint when it was arthrotic before the osteotomy. Nevertheless, the authors conclude that an associated transposition of the tibial tubercle in association with upper tibial osteotomy is not worthwhile, since no failure in their series could be attributed to impairment of the patello-femoral joint.
对因膝关节骨关节炎行胫骨上段截骨术后10多年的髌股关节进行了渐进性放射学变化研究。发现变化极小。在截骨术前髌股关节间隙正常的病例中，10年后仍保持正常。在截骨术前髌股关节间隙异常的病例中，一半在10年后病情恶化，髌骨内侧小关节面的病变更为严重。这种变化发生在11例中。它不受外翻截骨的程度、胫股关节间隙的变化或截骨技术的影响。功能结果仅与胫股关节间隙的变化相关，而与髌股关节间隙的变化无关。然而，当截骨术前髌股关节为关节炎时，即使胫股关节间隙结果良好，仍可能伴有髌股关节疼痛。尽管如此，作者得出结论，胫骨结节移位联合胫骨上段截骨术并不值得，因为他们的系列病例中没有失败可归因于髌股关节的损害。
