Wang J W
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Kaohsiung, Chang Gung Medical College, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1995 Jun;18(2):185-9.
An unusual postoperative knee pain caused by fabellar impingement after total knee replacement is described. A 68-year-old woman with knee arthrosis had large fabellae in both knees. She had total knee replacements of both knees. One knee developed fabellar impingement to the knee prosthesis, while the other knee was free of symptoms due to simultaneous fabellectomy during knee replacement. At 3-month postoperative follow-up, pain and local tenderness at posterolateral aspect of the left knee was noted during flexion up to 90 degrees. Physical examination revealed a tender fabella on the posterolateral part of the left knee. The lateral radiograph of the knee revealed a large fabella impinging on the prosthesis. The symptoms and signs were alleviated after surgical excision of the fabella. Careful evaluation of the preoperative lateral radiograph of the knee is necessary to detect a large fabella. If it is present and larger than 1 cm, excision during knee replacement is recommended.
描述了全膝关节置换术后因髌骨撞击引起的一种不寻常的膝关节疼痛。一名68岁患膝关节病的女性双膝有大的髌骨。她接受了双膝全膝关节置换术。一侧膝关节出现髌骨对膝关节假体的撞击，而另一侧膝关节由于在膝关节置换术中同时进行了髌骨切除术而无症状。术后3个月随访时，左膝关节屈曲至90度时，在膝关节后外侧出现疼痛和局部压痛。体格检查发现左膝关节后外侧有压痛的髌骨。膝关节外侧X线片显示一个大的髌骨撞击假体。髌骨手术切除后症状和体征缓解。术前仔细评估膝关节外侧X线片以检测大的髌骨是必要的。如果存在且大于1厘米，建议在膝关节置换术中切除。
