Naranja R J, Reilly P J, Kuhlman J R, Haut E, Torg J S
University of Pennsylvania, Department of Orthopaedic Surgery, Philadelphia, USA.
Am J Sports Med. 1996 Nov-Dec;24(6):779-84. doi: 10.1177/036354659602400613.
We evaluated 55 knees in 51 patients after Elmslie-Trillat-Maquet procedures. The procedure involves medialization of the tibial tubercle on a distal pedicle and elevating the tibial tubercle anteriorly 10 mm with a local bone graft. At a mean followup of 74.2 months (range 13 to 196), all patients completed postoperative surveys and 38 underwent postoperative examinations. Subjectively, 9 knees (16%) had excellent results, 24 knees (44%) obtained good results, and 13 knees (24%) had fair results for a total of 84% improvement overall. Using Fulkerson's functional knee score, 19 knees (35%) had excellent results, 10 knees (18%) had good results, and 11 knees (20%) had fair results for a total of 73% improvement overall. A total of 24 knees (44%) required later screw removal. The most significant findings of this study include 1) an 84% overall subjective improvement in symptoms; 2) the findings that young patients without evidence of progressive osteoarthrosis and with patella instability as a primary symptom tend to have the most favorable outcome; and 3) 24 knees (44%) required later screw removal.
我们对51例患者的55个膝关节进行了Elmslie-Trillat-Maquet手术后评估。该手术包括在远端蒂上使胫骨结节内移，并使用局部骨移植将胫骨结节向前抬高10毫米。平均随访74.2个月（范围13至196个月），所有患者均完成了术后调查，38例接受了术后检查。主观上，9个膝关节（16%）结果优秀，24个膝关节（44%）结果良好，13个膝关节（24%）结果尚可，总体改善率达84%。使用Fulkerson功能性膝关节评分，19个膝关节（35%）结果优秀，10个膝关节（18%）结果良好，11个膝关节（20%）结果尚可，总体改善率达73%。共有24个膝关节（44%）需要后期取出螺钉。本研究的最重要发现包括：1）症状总体主观改善率达84%；2）无进行性骨关节炎证据且以髌骨不稳定为主要症状的年轻患者往往预后最佳；3）24个膝关节（44%）需要后期取出螺钉。
