Open and Arthroscopic Patellar Tenotomy for Chronic Patellar Tendinopathy
Open and Arthroscopic Patellar Tenotomy for Chronic Patellar Tendinopathy
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开放式和关节镜下髌腱切断术治疗慢性髌腱病
DOI：
10.1177/03635465000280020801
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
J. Wark
中科院分区：
文献类型：
--
作者：
B. D. Coleman;K. Khan;K. Khan;Z. S. Kiss;J. Bartlett;D. Young;J. Wark
慢性髌腱病往往需要手术治疗。我们比较了25例接受开放式髌腱切断术的受试者（29条肌腱）和23例接受关节镜髌腱切断术的受试者（25条肌腱）的结局，平均随访时间分别为3.8年和4.3年。随访时，开放组和关节镜组的结局如下：1）81%的开放手术患者和96%的关节镜下肌腱切开术患者的症状受益，2）54%的开放手术患者和46%的关节镜下肌腱切开术患者的运动成功，3）开放手术患者恢复到损伤前活动水平的中位时间为10个月，关节镜下肌腱切开术患者为6个月，4）随访时维多利亚体育协会评估评分中位值为开放性肌腱切开术患者88分，关节镜肌腱切开术患者77分。两组之间的所有结局均无显著差异。在随访时，超过70%的受试者的肌腱超声表现仍然异常，超声表现与临床结果无关。因此，关节镜下髌腱切断术与传统开放手术一样成功。这两种手术几乎都为所有受试者提供了症状获益，但接受开放式或关节镜下髌腱切断术的受试者中，只有约一半在随访时仍能保持其以前的运动水平。
Chronic patellar tendinopathy often requires surgical treatment. We compared the outcomes in 25 subjects (29 tendons) who had had open patellar tenotomy and 23 subjects (25 tendons) who had had arthroscopic patellar tenotomy at a mean follow-up of 3.8 and 4.3 years, respectively. At follow-up, outcomes in the open and arthroscopic groups were as follows: 1) symptomatic benefit was seen in 81% of open and 96% of arthroscopic tenotomy patients, 2) sporting success was seen in 54% of open and 46% of arthroscopic tenotomy patients, 3) median time to return to preinjury level of activity was 10 months for open and 6 months for arthroscopic tenotomy patients, and 4) median Victorian Institute of Sport Assessment score at follow-up was 88 for open and 77 for arthroscopic tenotomy patients. There were no significant differences between groups for all outcomes. The appearance of the tendon on sonography remained abnormal in over 70% of subjects at follow-up, and sonographic appearance did not correlate with clinical outcome. Thus, arthroscopic patellar tenotomy was as successful as the traditional open procedure. Both procedures provided virtually all subjects with symptomatic benefit, but only about half the subjects who underwent either open or arthroscopic patellar tenotomy were competing at their former sporting level at follow-up.