Ogata K, Ishinishi T, Hara M
Fukuoka University Hospital, Japan.
J Arthroplasty. 1997 Sep;12(6):651-6. doi: 10.1016/s0883-5403(97)90138-8.
Tension of a suture placed to the patella to close the medial capsule during 35 primary total knee arthroplasties was measured. The increase in tension with flexion after arthrotomy was significantly smaller in 10 knees with a subvastus incision (subvastus group) than in 25 knees with a standard medial parapatellar incision (standard group). With the prosthesis in place, the patella showed maltracking with the no-thumb technique in 1 knee (10%) of the subvastus group and in 9 knees (36%) of the standard group. A lateral retinacular release was performed in 5 of these 10 knees but not in the remaining 5 knees because the increase in tension was a minimum. There was no case of patellar maltracking at an average follow-up period of 2.1 years after surgery, suggesting that a lateral release is not always needed if retinacular tension shows no significant increase, even cases where the patella dislocates with the no-thumb technique.
在35例初次全膝关节置换术中，测量了用于闭合内侧关节囊的髌骨缝线张力。关节切开术后，10例采用股直肌下切口的膝关节（股直肌下组）与25例采用标准内侧髌旁切口的膝关节（标准组）相比，屈曲时张力增加明显更小。假体就位后，股直肌下组1例膝关节（10%）和标准组9例膝关节（36%）采用无拇指技术时髌骨出现轨迹不良。这10例膝关节中有5例行外侧支持带松解，其余5例未行松解，因为张力增加最小。术后平均随访2.1年，无髌骨轨迹不良病例，这表明如果支持带张力无明显增加，即使采用无拇指技术时髌骨脱位，也并非总是需要进行外侧松解。
