Scott R D
Orthop Clin North Am. 1979 Jan;10(1):129-37.
We are just beginning to fully appreciate the significant role of the patellofemoral joint in total knee replacement surgery. Most of the new generation prostheses have a flanged femoral component. The tendency is to make the flange more anatomic in shape as more attention is paid to patellar tracking. Most systems have an optional polyethylene button to resurface the patellar side of the patellofemoral joint, and indications for its use are increasing. Although pain relief with patellar buttons seems uniform, the potential complications of stress fracture, loosening, and wear must temper our enthusiasm for their use until there is longer follow-up. Vitallium hemiarthroplasty of the patella is available in prostheses with and without the requirement for cement fixation. Most investigators have good results in chondromalacia (as a secondary procedure), but the experience in the literature is small. Results have been poor when the femoral side of the joint has been involved. Metal to plastic isolated patellofemoral prostheses have been designed to treat disease on both sides of the patellofemoral joint or to salvage unflanged total knee replacements with residual patellofemoral symptoms. Short term experience has been promising.
我们才刚刚开始充分认识到髌股关节在全膝关节置换手术中的重要作用。大多数新一代假体都有带凸缘的股骨部件。随着对髌骨轨迹的关注度不断提高，趋势是使凸缘的形状更符合解剖结构。大多数系统都有一个可选的聚乙烯纽扣，用于对髌股关节的髌骨面进行表面置换，并且其使用指征正在增加。尽管使用髌骨纽扣缓解疼痛似乎是一致的，但在有更长随访时间之前，应力性骨折、松动和磨损等潜在并发症必须让我们在使用它们时保持谨慎。有带和不带骨水泥固定要求的假体可供选择进行髌骨的维塔利姆半关节置换。大多数研究者在治疗软骨软化症（作为二次手术）方面取得了良好效果，但文献中的经验较少。当关节的股骨侧受累时，效果不佳。金属对塑料的孤立髌股假体已被设计用于治疗髌股关节两侧的疾病，或挽救有残留髌股症状的无凸缘全膝关节置换。短期经验很有前景。
