髌股关节骨关节炎手术治疗专家共识

Expert consensus on surgical treatment of patellofemoral osteoarthritis

髌股关节骨关节炎是中老年人膝前痛常见原因之一,一般优先选择基础治疗和药物治疗,如果规范的非手术治疗无法取得满意效果,可考虑选择手术治疗。髌股关节骨关节炎手术方式主要包括修复手术和重建手术两大类,术式选择主要取决于发病原因、发病机制、病变部位和严重程度。为帮助骨科医生科学进行临床决策,国家老年疾病临床医学研究中心(湘雅医院)和中华医学会骨科学分会关节外科学组共同组织国内骨科专家,深入总结髌股关节骨关节炎手术治疗现状与进展,并结合国内外最新髌股关节骨关节炎相关指南与共识,制定本专家共识,旨在为髌股关节骨关节炎手术方式的选择提供指导,减少手术创伤,提高手术疗效,改善患者生活质量并减轻疾病负担。

Patellofemoral osteoarthritis(PFOA)is one of the most common causes of anterior knee pain in middle-aged and elderly population.In general,elementary therapy and drug therapy are the preferred choices for PFOA management.However,for those who cannot achieve satisfactory effectiveness with standard non-surgical treatment,surgical therapy stands as an alternative treatment.The surgical therapy includes repair surgery and reconstruction surgery.The choice of surgical plans for PFOA management mainly depends on the etiology,pathogenesis,location,and severity of the lesions.To aid clinical decision-making,the National Clinical Research Center for Geriatric Disorders(Xiangya Hospital)and the Joint Surgery Branch of the Chinese Orthopedic Association arranged nationwide orthopedic specialists to set up a work panel.After reviewing the research progress of surgical therapy and the latest guidelines and consensus for PFOA management,the work panel discussed repeatedly to reach this consensus.The present consensus aims to provide valid evidences for clinical practices of the surgical therapy of PFOA,so as to avoid inappropriate and irregular treatment behaviors,reduce surgical trauma,improve surgical efficacy and the quality of life,and to ease the burden of PFOA.