Pan H Q, Kish V, Boyd R D, Burr D B, Radin E L
Bone and Joint Center, Henry Ford Hospital, Detroit 48202.
J Orthop Res. 1993 Mar;11(2):199-204. doi: 10.1002/jor.1100110207.
The Maquet procedure--elevation of the anterior tibial tubercle--has been recommended for treatment of symptomatic osteoarthrosis of the patellofemoral joint. Although the operation was first described 30 years ago, it remains controversial, both on a clinical and on a biomechanical basis. In addition, deterioration of the long-term results has been suggested. One of the variables that has been ignored in both clinical and biomechanical studies has been tibial shingle length. In order to judge its effect, we examined contact pressures and areas in 15 cadaver knees with 7 and 20 cm tibial shingle lengths. We found significant patellofemoral pressure diminution only with 2 cm elevations. The short anterior tibial shingle with 2 cm of elevation tipped the patella on its superior pole, with a significant change in angle between the patella and the shingle. We suggest that this creates a potentially less than desirable biomechanical circumstance and believe it may explain the discrepancies among previously published reports.
马凯特手术——胫骨结节前移术——已被推荐用于治疗有症状的髌股关节骨关节炎。尽管该手术在30年前首次被描述，但在临床和生物力学方面仍存在争议。此外，有人提出长期效果会恶化。在临床和生物力学研究中都被忽视的一个变量是胫骨垫板长度。为了判断其影响，我们检查了15具尸体膝关节在胫骨垫板长度为7厘米和20厘米时的接触压力和面积。我们发现只有抬高2厘米时髌股压力才会显著降低。抬高2厘米的短胫骨前垫板使髌骨在其极点处倾斜，髌骨与垫板之间的角度发生了显著变化。我们认为这可能会造成潜在的不理想生物力学情况，并相信这可能解释了先前发表的报告之间的差异。
