Harilainen A, Sandelin J
Orthopaedic Hospital of the Invalid Foundation, Helsinki, Finland.
Knee Surg Sports Traumatol Arthrosc. 1993;1(2):100-3. doi: 10.1007/BF01565461.
Among 53 prospectively studied patients who had undergone operative treatment of primary patellar dislocation, 9 (17%) suffered recurrence within an average follow-up of 6.5 years. All the redislocations occurred in female patients. The patients with recurrence also suffered first-time patellar dislocation in their unoperated knee during the follow-up significantly more often (P < 0.01) than the patients with stable knees. Patients with redislocations were more often dissatisfied with their outcome than the stable group, mainly because of annoying anterior knee pain (P < 0.05). Preoperatively the patients with redislocation had had more pronounced pathological patellofemoral congruity (Laurin's projections) in both the operated knee (P < 0.05) and the, at the time uninjured, control knee (P < 0.05). To improve the results of operative treatment for acute patellar dislocation, surgery should be aimed at correcting the underlying pathology. In grossly and symmetrically pathological cases of patellofemoral articulation, a distal realignment procedure should be considered. Otherwise conservative treatment may be justified.
在53例接受原发性髌骨脱位手术治疗的前瞻性研究患者中，9例（17%）在平均6.5年的随访期内复发。所有再次脱位均发生在女性患者中。与膝关节稳定的患者相比，复发患者在随访期间未手术侧膝关节首次发生髌骨脱位的情况也明显更频繁（P<0.01）。与稳定组相比，再次脱位的患者对其治疗结果更不满意，主要是因为恼人的膝前疼痛（P<0.05）。术前，再次脱位的患者在患侧膝关节（P<0.05）以及当时未受伤的对照侧膝关节（P<0.05）中，髌股关节匹配度的病理改变更为明显（劳林投影）。为提高急性髌骨脱位的手术治疗效果，手术应旨在纠正潜在的病理改变。在髌股关节明显且对称的病理情况下，应考虑进行远端重新排列手术。否则，保守治疗可能是合理的。
