髌股关节炎的治疗进展
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作者Author单位AddressE-Mail
张中兴 ZHANG Zhong-xing 广西医科大学附属柳铁中心医院关节骨病科, 广西 柳州 545007 Department of Arthroplasty and Bone Disease, Liutie Central Hospital Affiliated to Guangxi Medical University, Liuzhou 545007, Guangxi, China 17044120@qq.com 
许峰 XU Feng 广西医科大学附属柳铁中心医院关节骨病科, 广西 柳州 545007 Department of Arthroplasty and Bone Disease, Liutie Central Hospital Affiliated to Guangxi Medical University, Liuzhou 545007, Guangxi, China  
杨小龙 YANG Xiao-long 广西医科大学附属柳铁中心医院关节骨病科, 广西 柳州 545007 Department of Arthroplasty and Bone Disease, Liutie Central Hospital Affiliated to Guangxi Medical University, Liuzhou 545007, Guangxi, China  
期刊信息:《中国骨伤》2018年,第31卷,第7期,第684-688页
DOI:10.3969/j.issn.1003-0034.2018.07.019
基金项目:
中文摘要:髌股关节炎是最常见的膝关节疾病之一,目前髌股关节炎的诊治尚无明确的临床共识,保守治疗仅对于早期、单一的疾病阶段有一定的价值,随着对发病机制认识的不断进步和手术技术的改进,微创和关节置换技术得到了飞速的发展,可选择的治疗方案越来越多,早期曾采用的胫骨结节截骨、髌骨切除等技术目前已少见临床应用。根据疾病的发展阶段,并结合患者的年龄、经济能力、术后膝关节功能要求等因素综合考虑,关节镜下的软组织平衡和去神经化对于软骨损伤Ⅰ-Ⅲ级的老年患者是较为合适的术式,而软骨损伤Ⅳ级的老年患者,关节置换的效果更理想,早期争论在于全膝关节置换术是否存在过度医疗,随着假体设计的改进,髌股关节置换术满足了单一髌股关节退变的置换需求。由于软骨移植技术的手术难度大,加之髌股关节的解剖特性,目前髌股关节炎的软骨移植应用报道较少,但随着技术的不断改进,软骨移植技术将会是改善临床症状、降低医疗费用、推迟关节置换时间的一种很好的选择方案。
【关键词】髌股关节  关节炎  综述文献
 
Progress on treatment for patellofemoral arthritis
ABSTRACT  As a common disease of knee joint disease,the diagnosis and treatment of patellofemoral arthritis has not clear clinical consensus at present,conservative treatment only has a certain value for the disease with early stage and single disease. With the continuous improvement of understanding of pathogenesis and advancement of surgical techniques,minimally invasive and joint replacement technology has been rapid development,more and more alternative treatment options could be chosen. Technique of osteotomy of tibial tuberosity and removal of patella at the early stage were seldom used. According to development stage of disease,and combined with age,economic capacity,patients considering knee joint functional requirements and other factors,the balance of soft tissue under arthroscopy and denervation for cartilage injury in elderly patients with grade Ⅰto Ⅲ surgery is more appropriate,and joint replacement is effective for cartilage injury in elderly patients with grade IV. Early debate is focus on total knee arthroplasty whether exist excessive medical treatment,patellofemoral joint replacement meet to demand for replacement of single patellofemoral degeneration with improvement of prosthesis design. Due to technical difficulties of cartilage transplantation and anatomical characteristics of patellofemoral joint,report of application of cartilage transplantation for patellofemoral arthritis is less,but with continuous improvement of technology,cartilage transplantation will be a good method for improving clinical symptoms,reducing medical costs,putting off joint replacement time.
KEY WORDS  Patellofemoral joint  Arthritis  Review literature
 
引用本文,请按以下格式著录参考文献:
中文格式:张中兴,许峰,杨小龙.髌股关节炎的治疗进展[J].中国骨伤,2018,31(7):684~688
英文格式:ZHANG Zhong-xing,XU Feng,YANG Xiao-long.Progress on treatment for patellofemoral arthritis[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(7):684~688
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