[Retro-trochlear wedge reduction trochleoplasty for the treatment of painful patella syndrome with protruding trochleae. Technical note and early results].

医学 胫骨粗隆 髌骨 外科 截骨术 放射性武器 还原(数学) 数学 几何学
作者
D Goutallier,D. Raou,Stephane van Driessche
出处
期刊:PubMed 卷期号:88 (7): 678-85 被引量:68
链接
标识
摘要

Patients with painful patella syndrome without objective instability are often treated by section of the lateral retinacular of the patella or advancement osteotomy of the tibial tuberosity with less than satisfactory mid-term results. One explanation of the persistent pain could be hyperpression within the femoro-patellar joint due to excessive protrusion of the trochleae (>=7 mm). We propose retro-trochlear wedge resection to achieve reduction trochleoplasty. The wedge is cut with a superior base so the trochlear angle remains unchanged. We describe here the operative technique and report early results at more than two years follow-up.We reviewed retrospectively 12 knees treated with trochleoplasty for painful patella syndrome. Eleven of these knees had had previous operations for objective (n=9) or potential (n=2) patellar instability. Mean follow-up was 4 years (range 2-6). A complete pre- and postoperative radiological work-up was obtained for all knees including 30 degrees flexion femoropatellar views and computed tomography measurements of TA-GT value at 30 degrees flexion. Functional outcome was studied with the Arpege scale. Trochleoplasty was performed via an anterolateral approach and was associated with frontal translation of the tibial tuberosity if the preoperative TA-GT was not in accord with the trochlear angle.Functional outcome improved during the first two postoperative years then stabilized. Improvement in pain and instability was statistically significant. Functional outcome was scored good or very good for nine knees. The two failures occurred in the oldest patients whose knees had had several operations. Mean trochlear protrusion was 8 mm preoperatively and 3 mm postoperatively. All trochleoplasties healed; there was no trochlear necrosis.The described trochleoplasty has an advantage over classical reduction trochleoplasty because it does not modify the trochlear angle. In addition, it is quantifiable. It is biomechanically more logical than advancement of the tibial tuberosity. In our patients, the trochlear protuberance was reduced to 3 mm. Associated with correction of mechanical femoro-patellar anomalies in the frontal plane, this trochleoplasty can provide good relief even in patients with persistent pain in previously operated knees treated for objective or potential patellar instability or for simple patellar pain.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
每每反完成签到,获得积分10
1秒前
凡凡完成签到 ,获得积分10
2秒前
3秒前
呆鹅喵喵完成签到,获得积分10
3秒前
忧心的洙完成签到,获得积分10
4秒前
123完成签到,获得积分10
4秒前
青青草完成签到,获得积分10
6秒前
Fang Xianxin完成签到,获得积分20
6秒前
yue发布了新的文献求助10
6秒前
小甘看世界完成签到,获得积分0
8秒前
量子星尘发布了新的文献求助10
8秒前
张今天也要做科研呀完成签到,获得积分10
9秒前
nater3ver完成签到,获得积分10
10秒前
10秒前
自然怀梦完成签到,获得积分10
10秒前
轻歌水越完成签到 ,获得积分10
10秒前
执意完成签到 ,获得积分10
11秒前
大模型应助Coral采纳,获得10
11秒前
songyl完成签到,获得积分10
12秒前
怡然问晴发布了新的文献求助20
13秒前
24K纯帅完成签到,获得积分0
13秒前
LL发布了新的文献求助20
13秒前
飒飒发布了新的文献求助10
15秒前
JamesPei应助幸福广山采纳,获得10
16秒前
莫封叶完成签到,获得积分10
16秒前
iiiau完成签到,获得积分10
17秒前
ersan发布了新的文献求助10
17秒前
小蘑菇完成签到,获得积分10
18秒前
Loooong应助李cc采纳,获得10
18秒前
单纯乞完成签到,获得积分10
18秒前
18秒前
赘婿应助科研通管家采纳,获得10
19秒前
NexusExplorer应助科研通管家采纳,获得10
19秒前
19秒前
搜集达人应助科研通管家采纳,获得10
19秒前
打打应助科研通管家采纳,获得10
19秒前
Mars应助科研通管家采纳,获得10
19秒前
19秒前
7733完成签到,获得积分10
19秒前
Perry应助科研通管家采纳,获得50
19秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038303
求助须知:如何正确求助?哪些是违规求助? 3576013
关于积分的说明 11374210
捐赠科研通 3305780
什么是DOI,文献DOI怎么找? 1819322
邀请新用户注册赠送积分活动 892672
科研通“疑难数据库(出版商)”最低求助积分说明 815029