Arnold M P, Friederich N F, Widmer H, Müller W
Klinik für Orthopädische Chirurgie und Traumatologie des Bewegungsapparates, Kantonsspital Bruderholz, Schweiz.
Orthopade. 1998 Sep;27(9):637-41.
As shown in long term follow-up studies of Total Knee Arthroplasty (TKA), the femoropatellar joint is an important problem. We report our experience over the past seven years not having resurfaced the patella at the primary TKA at all. Between 1990 and 1997 more than 700 consecutive TKA with the De Puy New Jersey LCS prosthesis were performed. A standardised lateral approach with osteotomy of the tibial tuberosity was used. The patella was redressed, either denervated or left untouched. In no case a primary patellar resurfacing was performed. X-rays of the patello-femoral joint showed a remodelling of the patella over the years, nicely matching the condylar design of the femoral prosthesis. Using a blood-supply-preserving approach and a biomechanically adequate implant, TKA without patellar replacement gives excellent long-term results.
全膝关节置换术（TKA）的长期随访研究表明，髌股关节是一个重要问题。我们报告过去七年在初次全膝关节置换术中完全不进行髌骨表面置换的经验。1990年至1997年间，连续进行了700多例使用De Puy新泽西LCS假体的全膝关节置换术。采用标准化的外侧入路并进行胫骨结节截骨术。对髌骨进行修整，要么去神经化，要么保持原状。在任何情况下均未进行初次髌骨表面置换。髌股关节的X线片显示，多年来髌骨发生了重塑，与股骨假体的髁设计完美匹配。采用保留血供的方法和生物力学上合适的植入物，不进行髌骨置换的全膝关节置换术可取得优异的长期效果。
