Mendes D G, Soudry M, Iusim M
Clin Orthop Relat Res. 1987 Sep(222):228-38.
Advancement of the tibial tuberosity (TTA) or Maquet procedure is a controversial procedure. Between 1978 and 1982, 27 consecutive patients were treated by TTA with an average follow-up period of 5.5 years in 25 patients. In eleven cases with concomitant medical compartment osteoarthritis, TTA was combined with high tibial osteotomy (HTO). Patellar pain relief was noted soon after surgery and was sustained in 80% of the patients. Systemic complications included one patient with lethal pulmonary embolus. Local complications occurred as follows: three patients had severe local necrosis of skin, which required a rotation skin flap in two. In one patient, the bone graft displaced, and in two patients, nonunion of this graft was noted. Following appropriate treatment in these six patients their final rating was excellent in two, good in three, and poor in one. Contrary to other reports in the literature, the combination of HTO and TTA was as successful as the Maquet procedure alone. TTA is an important procedure for severe patellofemoral arthritis after all other methods of conservative treatment have been exhausted and no other surgical procedure is clearly indicated.
胫骨结节前移术（TTA）或马凯特手术是一种存在争议的手术。1978年至1982年间，连续27例患者接受了TTA治疗，其中25例患者的平均随访期为5.5年。在11例合并内侧间室骨关节炎的病例中，TTA与高位胫骨截骨术（HTO）联合应用。术后很快就注意到髌前疼痛缓解，80%的患者疼痛持续缓解。全身并发症包括1例致死性肺栓塞患者。局部并发症如下：3例患者出现严重的局部皮肤坏死，其中2例需要行旋转皮瓣术。1例患者骨移植块移位，2例患者出现移植骨不愈合。这6例患者经过适当治疗后，最终评级为2例优秀，3例良好，1例差。与文献中的其他报道相反，HTO和TTA联合应用与单纯马凯特手术同样成功。在所有其他保守治疗方法均已用尽且没有明确指征进行其他手术的情况下，TTA是治疗严重髌股关节炎的一项重要手术。
