Moharana Siddharth Sekhar, De Indraneel, Panda Siddharth, Jeetendra Chekuri, Rana Rajesh
Department of Orthopaedics, IMS and SUM Hospital, Bhubaneswar, Odisha, India.
Department of Orthopaedics, Jagannath Gupta Institute of Medical Science and Hospital, Budgebudge, West Bengal, India.
J Orthop Case Rep. 2023 Apr;13(4):53-56. doi: 10.13107/jocr.2023.v13.i04.3614.
Avascular necrosis (AVN) of patella is a very rare condition and occurs in very few case. Although underlying etiology is still unknown, some expert suggest that its due to interruption of blood supply to patella which may be due to high velocity trauma or may be due to long term history of steroid intake. Here are the findings of our case AVN patella and reviews of earlier literature.
We present a case of a AVN patella in a 31-year-old male. The patient presented with pain in knee with stiffness and tenderness at knee followed by decrease range of movement of knee. Magnetic resonance imaging showed irregular cortical outline of patella with degenerative osteophytes-suggestive of osteonecrosis of patella. It was treated conservatively with physiotherapy for range of movement of knee.
ORIF with extensive exploration and infection may compromise that the vascularity of patella may lead to AVN of patella. As the disease is non-progressive, it is better to manage such patients conservatively with range of movement brace so as to decrease the chance of complication associated with surgical intervention.
髌骨缺血性坏死（AVN）是一种非常罕见的病症，病例极少。尽管其潜在病因仍不明，但一些专家认为这是由于髌骨血液供应中断所致，这可能是由于高速创伤，也可能是由于长期服用类固醇药物的病史。以下是我们这例髌骨缺血性坏死病例的研究结果及对早期文献的综述。
我们报告一例31岁男性的髌骨缺血性坏死病例。患者表现为膝关节疼痛、僵硬，膝关节压痛，随后膝关节活动范围减小。磁共振成像显示髌骨皮质轮廓不规则，伴有退行性骨赘，提示髌骨骨坏死。对其进行了物理治疗以恢复膝关节活动范围的保守治疗。
进行广泛探查和感染的切开复位内固定术（ORIF）可能会损害髌骨的血供，从而导致髌骨缺血性坏死。由于该疾病不会进展，对于此类患者，最好采用活动范围支具进行保守治疗，以减少与手术干预相关的并发症发生几率。
