Radin E L
Clin Orthop Relat Res. 1979 Oct(144):107-9.
Chondromalacia of the patella should be considered a separate entity and not the necessary precursor of osteoarthrosis. It is rarely associated with significant discomfort. Isolated softening, fibrillation of the central medial facet, and a diagnosis of chondromalacia of the patella should be limited, in our view, to isolated fibrillation occurring in the central medial facet and is probably asymptomatic. Symptomatic patellar pain can be treated by realignment if the patella is malaligned, by lateral release and synovial fringe excision if there is an anomalous facet or synovial fringe entrapment syndrome, and by drilling and curettage and stress-relieving operations (if necessary) if there is an osteochondral injury. For osteoarthrosis stress can be relieved on a permanent basis by the Maquet anterior tibial tubercle advancement operation. We recommend approaching patellofemoral pain by establishing a specific diagnosis and applying a specific treatment.
髌骨软骨软化症应被视为一个独立的病症，而非骨关节炎的必然先兆。它很少会引起明显不适。我们认为，孤立的软化、中央内侧小面的纤维化以及髌骨软骨软化症的诊断应仅限于中央内侧小面出现的孤立性纤维化，且可能无症状。如果髌骨排列不齐，有症状的髌前疼痛可通过重新排列进行治疗；如果存在异常小面或滑膜皱襞卡压综合征，则通过外侧松解和滑膜皱襞切除术治疗；如果存在骨软骨损伤，则通过钻孔、刮除术以及必要时的应力缓解手术治疗。对于骨关节炎，可通过马凯特胫骨结节前移手术永久性缓解应力。我们建议通过明确具体诊断并采取具体治疗方法来处理髌股关节疼痛。
