Griffiths G P, Selesnick F H
Miami Sports Medicine Fellowship, Coral Gables, Florida 33143, USA.
Arthroscopy. 1998 Nov-Dec;14(8):836-9. doi: 10.1016/s0749-8063(98)70020-9.
Patellar tendinitis is a well-described clinical entity that usually responds well to conservative treatment. However, a subset of patients continue with symptoms despite exhaustive nonoperative means. The objective of the study was to review the treatment course and operative results of seven patients (eight knees) with chronic patellar tendinitis treated surgically. Five (70%) of these patients were either professional or collegiate athletes. The average age was 30 years (range, 20 to 45 years). Duration of symptoms averaged 1.4 years (range, 3 months to 4 years) before surgical correction. Operative treatment included knee arthroscopy and open repair consisting of excision of degenerated tissue and stimulation of a healing response of the patellar tendon pathology. Operative findings and pathology reports consistently showed marked fibrotendinous degeneration. Follow-up averaged 3.6 years (range, 4 months to 8.5 years). Outcomes were measured subjectively with SF36 results and objectively with Biodex testing (Biodex, Shirley, NY) and return to previous level of competition. Overall, 86% of patients achieved an excellent result and 14% had a fair result. We recommend operative intervention in a patient with chronic patellar tendinitis who does not improve with well-supervised, comprehensive conservative treatment.
髌腱炎是一种描述详尽的临床病症，通常对保守治疗反应良好。然而，尽管采取了全面的非手术治疗手段，仍有一部分患者症状持续存在。本研究的目的是回顾7例（8膝）接受手术治疗的慢性髌腱炎患者的治疗过程及手术结果。其中5例（70%）患者为职业或大学运动员。平均年龄为30岁（范围20至45岁）。手术矫正前症状持续时间平均为1.4年（范围3个月至4年）。手术治疗包括膝关节镜检查和开放修复，即切除退变组织并刺激髌腱病变的愈合反应。手术所见和病理报告均一致显示明显的纤维肌腱退变。随访平均3.6年（范围4个月至8.5年）。采用SF36结果进行主观评估，通过Biodex测试（Biodex，纽约州雪莉）进行客观评估，并观察患者是否恢复到先前的竞技水平。总体而言，86%的患者取得了优异的结果，14%的患者结果尚可。对于经过精心监督的全面保守治疗后仍无改善的慢性髌腱炎患者，我们建议采取手术干预。
