Hofmann G O, Hagena F W
Clinic and Policlinic of Surgery, Ludwig-Maximilians-University, Munich, Federal Republic of Germany.
Clin Orthop Relat Res. 1987 Nov(224):251-9.
Persistent discomfort in the femoropatellar joint is still one of the most disappointing aspects following total knee arthroplasty (TKA). Especially, TKA without patellofemoral replacement has a significant incidence of patellofemoral problems with a frequency between 5% and 45%. Pathomechanical factors in the development of retropatellar problems are loss of patellar thickness and retropatellar erosions. In 157 TKAs using Gschwend, Scheier, Bähler (GSB) joints without patellar resurfacing, pathomechanically postoperative vertical patellar malposition appeared to be the main cause of dysfunction. In many cases, the implantation technique leads to an artificial form of patella alta. This altered knee anatomy results in pathologic biomechanics, thus leading to reduced function. The combination of altered anatomy and reduced function leads to extensive patellar destruction and ultimately to intractable retropatellar pain.
股髌关节持续不适仍是全膝关节置换术（TKA）后最令人失望的方面之一。特别是，未进行髌股关节置换的TKA出现髌股问题的发生率很高，频率在5%至45%之间。髌后问题发展中的病理力学因素是髌股厚度丧失和髌后侵蚀。在157例使用Gschwend、Scheier、Bähler（GSB）关节且未进行髌骨表面置换的TKA中，术后髌股垂直位置异常在病理力学上似乎是功能障碍的主要原因。在许多情况下，植入技术会导致人为的高位髌骨。这种改变的膝关节解剖结构会导致病理生物力学，从而导致功能下降。解剖结构改变和功能下降的结合会导致广泛的髌骨破坏，并最终导致难以治疗的髌后疼痛。
