全膝关节置换术后腘窝肌腱病变的诊断与治疗

J. R. Martin, Alison R. Fout, Andrew C Stoeckl, D. Dennis
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引用次数: 3

摘要

以下是4例初次全膝关节置换术后出现膝关节后外侧疼痛的患者,术后平均随访时间为1.6个月。本系列的第一位患者在试图外展腿以调整床上床单时,发现躺在床上(手术腿向上,侧卧位)有明显的疼痛。进行了彻底的临床和放射检查。该患者在床上的姿势(以及随后的体检动作)导致推定诊断为腘肌腱病变。经关节镜检查确认腘肌腱磨损和发炎。在接受关节镜腘肌腱松解术后,患者发现疼痛完全缓解,同时在屈曲和伸展时保持冠状稳定。以下办公室提示定义了先前未描述的腘肌腱病变的临床诊断检查,该检查是根据患者的症状确定的,随后用于确定关节镜下确认的另外三例腘肌腱病变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnosing and Treating Popliteal Tendinopathy After Total Knee Arthroplasty
The following office tip describes four patients that underwent primary total knee arthroplasty and developed posterolateral knee pain at a mean follow-up duration of 1.6 months postoperatively. The first patient in this series noted substantial pain lying in bed (in a lateral decubitus position with the operative leg up) while attempting to abduct her leg to adjust her sheet in bed. A thorough clinical and radiographic work-up was performed. This patient’s posturing in bed (and subsequent physical exam maneuver) led to a presumptive diagnosis of popliteal tendinopathy. The diagnosis was confirmed arthroscopically by identifying a frayed and inflamed popliteal tendon. After undergoing arthroscopic popliteal tendon release, the patient noted complete pain relief while retaining coronal stability in both flexion and extension. The following office tip defines a previously undescribed clinical diagnostic examination for popliteal tendinopathy that was identified based on a patient’s symptomatology and subsequently utilized to identify three additional cases of arthroscopically confirmed popliteal tendinopathy.
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