膝单髁置换术治疗外侧间室膝骨关节炎的中期随访研究

目的：分析膝单髁置换术（UKA）治疗外侧间室膝骨关节炎的中期临床疗效,并总结手术技术要点。方法：回顾性分析2014年3月至2018年12月采用UKA治疗的182例（186膝）外侧间室膝骨关节炎患者的临床资料。记录患者切口长度、手术时间及术后并发症等。膝关节正、侧位X线检查评估下肢力线和UKA股胫假体力线。末次随访时评估患者的牛津膝关节评分（OKS）、美国特种外科医院评分（HSS）、膝关节活动范围（ROM）及患者满意度。采用Kaplan-Meier法进行生存分析。结果：所有患者平均随访（63.9±15.3）个月（42～99个月）。切口平均长度（7.6±0.5）cm(6.5～9.0 cm)。平均手术时间（73.7±10.6）min(45～102 min)。末次随访时,所有患者的OKS评分、HSS评分及膝关节ROM均较术前显著改善（P<0.001）,患者满意度为94.1%。术后患者的下肢力线外翻较术前获得明显矫正（P<0.001）。X线及三维CT检查显示股骨假体外翻（0.9±4.7）°,后倾（30.4±9.2）°,内旋（-5.8±3.7）°。胫骨假体厚度为（9.8±1.2）mm,...     

单髁置换治疗膝单间室骨性关节炎

膝关节单髁置换术(unicompartmental knee arthroplasty,UKA)是指对膝关节内侧或外侧室进行表面置换,其主要目的是替换膝关节胫股骨受破坏的软骨表面。在膝关节的三个间室中,膝骨关节炎的特点是一个间室受累严重。当膝骨性关节炎仅仅累及到胫股关节单间室时,UKA是有效的治疗方法。笔者主要对该手术的发展历史、手术适应证及禁忌证、手术技术、临床疗效等方面的现状作一综述。     

胫骨侧固定垫片翻修更换垫片后再次脱位的牛津单髁置换术1例报道

<正>膝单髁置换术（unicompartmental knee arthroplasty,UKA）是治疗单间室膝骨关节炎的有效方法~[1]。1982年首次使用牛津单髁假体进行了膝关节单间室置换术。固定平台UKA与活动平台UKA在临床结果、影像学结果、翻修率和生存率方面差异无统计学意义~[2]。但是与固定平台UKA相比,活动平台UKA用于膝关节外侧间室置换时翻修的风险高4倍~[3]。     

髌旁外侧入路外侧单髁置换术治疗膝关节外侧间室骨关节炎

目的探讨采用髌旁外侧入路外侧单髁置换术(lateral unicompartmental knee arthroplasty,LUKA)治疗膝关节外侧间室骨关节炎的可行性及近期疗效。方法 2010年11月-2012年8月,收治15例(15膝)膝关节外侧间室骨关节炎患者。男7例,女8例;年龄51~82岁,平均67.3岁。病程3~15年,平均5.4年。左膝6例,右膝9例。骨关节炎根据Ahlback评级标准,Ⅰ级2例,Ⅱ级8例,Ⅲ级5例。采用LUKA治疗后,记录切口长度、手术时间、出血量、引流量和并发症发生情况;比较手术前后膝关节活动度、髋膝踝角,采用美国特种外科医院(HSS)评分法对手术前后膝关节功能进行评估。结果术中2例发现前交叉韧带断裂或内侧间室软骨磨损,改行全膝关节置换术;1例失访,其余12例获随访,随访时间26~45个月,平均32.5个月。获随访的12例患者切口长度为6~8 cm,平均6.9 cm;术中出血量105~250 m L,平均152.2 m L;手术时间90~155 min,平均115.8 min;术后24 h引流量为50~300 m L,平均145.6 m L。除2例切口发生浅表感染外,其余切口均Ⅰ期愈合。末次随访时,患膝关节HSS评分为(94.6±2.1)分,较术前(73.4±4.6)分显著提高(t=14.240,P=0.000);获优9例,良2例,可1例,优良率为91.7%。髋膝踝角由术前外翻(10.08±1.38)°减小至外翻(5.17±0.94)°,比较差异有统计学意义(t=14.626,P=0.000)。膝关节活动度为(123.75±4.09)°,亦较术前(108.67±5.10)°显著提高(t=8.998,P=0.000)。X线片检查示无关节脱位、假体松动及进展为内侧间室关节炎等并发症发生。结论对于外侧间室骨关节炎,在严格掌握适应证前提下,采用髌旁入路LUKA治疗具有膝关节功能恢复快、并发症少及创伤小的优势,近期疗效较好,远期疗效有待进一步观察明确。     

外侧固定平台膝单髁置换术后下肢力线变化分析

目的：观察固定平台膝单髁置换术（UKA）治疗外侧间室膝骨关节炎术后下肢力线矫正情况及短期临床疗效。方法：选择2018年8月至2022年2月收治的符合外侧UKA手术适应证的膝骨关节炎患者20例（22膝）进行回顾性分析。术前与术后3个月进行负重位双下肢全长X线检查,并测量下肢外翻角度;术后6个月对患者进行牛津大学膝关节评分（OKS）和美国膝关节协会评分（AKS）。结果：患者术前下肢均有一定程度的外翻,平均外翻角度为（4.1±2.7）°,术后3个月患者下肢外翻角度明显改善（P<0.05）,平均角度变化（3.8±1.8）°,手术前后外翻角度呈线性相关。同时,术后6个月患者AKS评分、OKS评分均较术前明显改善（P<0.01）。年龄较大（≥60岁）患者术前AKS评分低于年龄较小（<60岁）患者,而术前OKS评分高于年龄较小患者,且差异均有统计学意义（P<0.05）;患者性别、术侧对手术前后AKS评分和OKS评分均无明显影响。术前重度外翻（≥4°）患者术后AKS评分低于术前轻度外翻（<4°）患者,且差异有统计学意义（P<0.05）;术后内翻（<-1°）患者...     

单髁置换和全膝置换治疗内侧间室膝骨关节炎的早中期疗效比较

目的比较单髁关节置换术(UKA)和全膝关节置换术(TKA)治疗内侧间室膝骨关节炎的早中期疗效。方法将68例(70膝)内侧间室膝骨关节炎患者随机分成UKA组及TKA组。比较两组手术时间、术中出血量、术后引流量、住院天数,采用膝关节KSS评分、膝关节活动度(ROM)、人工关节被遗忘指数(FJS)评价手术效果。结果患者均获得随访,时间25~36个月。UKA组在手术时间、术中出血量、术后引流量、住院天数均低于TKA组,差异均有统计学意义(P0.01)。术后6周,UKA组的KSS评分及ROM均高于TKA组,差异均有统计学意义(P0.05)。术后6、12、24个月,UKA组的FJS评分均高于TKA组,差异均有统计学意义(P0.01)。结论 UKA治疗内侧间室膝骨关节炎是安全有效的方法,相比于TKA具有一定的优势。     

膝关节单髁置换术早中期并发症分析

1目的探讨膝关节单髁置换术（UKA）早中期并发症的原因及防治方法。方法回顾性分析2003～2013年本组行UKA共217膝的临床结果,对早中期并发症进行分析。男46膝,女171膝,平均年龄65．3岁。术前诊断为膝关节骨关节炎201膝,骨坏死16膝。结果术后平均随访5．8年,患者满意率87％,疼痛缓解率93％,膝活动度123°,HSS评分92分。所有病例无临床深静脉血栓和肺栓塞发生,无手术死亡病例。术后全膝关节置换翻修3例：1例假体松动、1例假体周围感染、1例对侧间室骨关节炎。Oxford半月板衬垫脱位2例,手术更换大号半月板衬垫。另有对侧间室骨关节炎1例未进行翻修。结论膝关节UKA治疗膝关节内侧间室病变中短期疗效满意,但存在特有并发症,应严格手术适应证、掌握手术操作原则及技术,完善围手术期处理,减少并发症的发生。     

全膝关节置换术与单髁置换术治疗内侧间室膝骨关节炎疗效对比的meta分析

背景:全膝关节置换术(TKA)及单髁置换术(UKA)均为治疗内侧间室膝骨关节炎终末期的有效方法,然而目前对于两种术式的治疗效果并没有统一结论。目的:对TKA和UKA治疗内侧间室膝骨关节炎的随机对照试验(RCT)进行meta分析。方法:检索PubMed、EMbase、Cochrane、中国知网、万方数据以及维普数据库,筛选比较TKA及UKA治疗内侧间室膝骨关节炎的RCT,检索时间截至2019年12月。由两名检索员严格按照纳入标准筛选文献并提取数据,所得数据均采用Review Manager 5.1.4进行meta分析。结果:最终20篇文献纳入本研究,其中英文文献3篇,中文文献17篇;共有患者1473例(1493膝):UKA组725例(733膝),TKA组756例(760膝)。在膝关节HSS评分、膝关节活动度、术后屈曲90°所需时间、手术时间、术中出血量及术后并发症方面,UKA组均优于TKA组(P<0.05);在膝关节KSS评分和疼痛缓解优良率方面,两组无明显统计学差异(P>0.05)。结论:相对于TKA治疗内侧间室膝关节骨关节炎,UKA能有效提高膝关节功能评分、膝关节活动度,降低术后屈曲90°所需时间、手术时间、术中出血量及术后并发症。     

外侧与内侧单髁置换术治疗膝关节单间室骨关节炎中期临床疗效的对比研究

背景:单髁关节置换术(UKA)常用于治疗膝关节单间室骨关节炎(OA)。由于膝外侧间室与内侧间室在解剖学和运动学方面均存在差异,外侧UKA被认为是一种技术难度上更具挑战性的手术。目的:比较膝关节外侧单髁关节置换术(LUKA)与膝关节内侧单髁关节置换术(MUKA)治疗膝关节单间室OA的中期临床疗效。方法:回顾性分析2012年3月至2016年3月接受UKA的265例患者的临床资料,其中Oxford 3活动平台MUKA 189例,LINK-Sled固定平台LUKA 76例。记录两组患者的手术时间、术中出血量、术后引流量、术后并发症等。通过HSS评分、OKS评分、WOMAC指数、FJS评分、膝关节ROM评估临床疗效。通过术后X线片测量影像学评估指标:胫骨假体内外翻角(TCVA)、胫骨假体后倾角(TCPSA)、股骨假体内外翻角(FCVA)、股骨假体屈曲角(FCPSA)。结果:随访时间为4~6年,平均(5.1±0.8)年。与MUKA相比,LUKA的手术时间长、术后引流量少、术后第1日的患肢肿胀程度轻以及膝关节活动度大(P<0.05),两组的术后下地时间、住院天数、手术出血量、术后第3日的患肢肿胀程度比较,差异均无统计学意义(P>0.05)。两组术前与末次随访的HSS评分、OKS评分、WOMAC及FJS评分比较,差异均无统计学意义(P>0.05)。两组的TCVA、TCPSA、FCVA、FCPSA比较,差异有统计学意义(P<0.05)。术后均未见假体无菌性松动、下沉等。MUKA组术后发生衬垫滑脱2例,下肢肌间静脉血栓2例,皮肤浅层感染1例;LUKA组出现1例膝内侧进展性OA,翻修采用MUKA。结论:LUKA技术要求更高,在严格把握手术适应证的基础上,不断提高手术技术,精准把握假体定位和屈伸间隙平衡,避免畸形矫正过度,可以获得与MUKA同样优良的临床疗效。     

微创与传统入路单髁置换术治疗膝关节单间室骨关节炎的疗效比较

目的:比较微创与传统入路单髁置换术(UKA)治疗膝关节单间室骨关节炎的临床效果.方法:回顾性研究2017年2月至2019年6月行UKA治疗的膝关节单间室骨关节炎患者74例(76膝),根据其手术切口的不同,分为微创入路组40膝与传统入路组36膝.比较两组患者的手术时间、切口长度、手术出血量、疼痛视觉模拟评分(VAS)、美...     

Osteotomies for lateral compartment knee osteoarthritis

Lateral compartment osteoarthritis (LCOA) is often associated with valgus deformity of the knee. The concept of correcting the alignment by performing distal femoral varus osteotomy (DFVO) to unload the lateral compartment is well accepted and it is viewed as the preferred option for young active patients due to dissatisfaction from arthroplasty under 55 years of age or if they wish to remain active. Beyond this there is no consensus on patient selection, preoperative assessment, techniques to achieve correction, end point of correction, return to work or sports post-surgery, and survivorship of osteotomy with conversion to a total knee replacement as the end point due to heterogenous, retrospective studies. Here, we review relevant literature to help patient selection, preoperative work up, techniques, and outcomes.     

A comparison of lateral release rates in fixed- versus mobile-bearing total knee arthroplasty

BackgroundWith increasing functional demands of patients undergoing total knee arthroplasty, mobile-bearing (MB) implants were developed in an attempt to increase the functional outcome of such patients. In theory, with MB implants, the self-alignment should reduce the rate of lateral release of the patella, which is usually performed to optimise patellofemoral mechanics. This study reports on the lateral release rates for the P.F.C. Sigma® MB posterior-stabilised total knee replacement (TKR) implant compared with its fixed-bearing (FB) equivalent.ResultsThe lateral release rate was the same for FB (10 %) and MB implants (10 %) (p = 0.9). However, patellar resurfacing resulted in lower lateral release rates when compared to patellar retention (6 vs 14 %; p = 0.0179) especially in MB implants (3 %).ConclusionsIt has been previously reported that alterations to the design of the P.F.C. system with a more anatomical trochlea in the femoral component improved patellar tracking. The addition of a rotating platform tibial component to the P.F.C. Sigma system has, on its own, had no impact on the lateral release rate in this study. Optimising patellar geometry by patellar resurfacing appears more important than tibial-bearing design. Although MB implants appear to reduce the need for lateral release in the P.F.C. Sigma Rotating Platform, this only occurs when the patellar geometry has been optimised with patellar resurfacing.

Level of evidence

Level 2.     

Which one restores in vivo knee kinematics effectively-medial or lateral pivot?

IntroductionTotal knee arthroplasty (TKA) usually provides good pain relief and improved function but has generally been unable to fully restore normal knee kinematics. Does Medial or Lateral Pivot TKA designs guide us to native knee kinematics needs to be elucidated?MethodsKinematic assessment of 13 knees with Medial Pivot TKA and 13 knees with Lateral Pivot TKA was done. The subjects were asked to perform step-up and weight bearing deep knee bend exercise under fluoroscopy for kinematic assessment. Patellar Tendon Angle (PTA) was measured after correcting f luoroscopic images for distortion against Knee Flexion Angle (KFA).ResultsDuring the weight bearing deep knee bend, the average active maximum flexion achieved with Medial Pivot design was 113.8 ͦ as compared to 102.9 ͦ with Lateral Pivot design. There was no significant difference in PTA in step up and deep knee bend exercise between both the designs.ConclusionThe kinematic assessment of both the Medial and Lateral Pivot TKA designs revealed linear trend of PTA with increasing KFA as described for normal knee. Both the designs were able to achieve functional knee range of motion.     

Arthroscopic lateral meniscectomy

Surgical Principle Partial or total arthroscopic lateral meniscectomy by triangulation. A special arthroscope is not necessary. Additional instruments are inserted through separate portals. The technique used was originally described by Gillquist [1–4] and modified based on information given by Glinz [5], Holder [6], and Klein and Schulitz [8]. Revised Version from: Operat. Orthop. Traumatol. 1 (1989), 53–61 (German Edition).     

Mechanical effectiveness of lateral foot wedging in medial knee osteoarthritis after 1 year of wear

The use of lateral foot wedging in the management of medial knee osteoarthritis is under scrutiny. Interestingly, there have been minimal efforts to evaluate biomechanical effectiveness with long‐term use. Therefore, we aimed to evaluate dynamic knee loading (assessed using the knee adduction moment) and other secondary gait parameters in patients with medial knee osteoarthritis wearing lateral foot wedging at a baseline visit and after 1 year of wear. Three‐dimensional gait data were captured in an intervention group of 19 patients with symptomatic medial knee osteoarthritis wearing their prescribed laterally wedged foot orthoses at 0 and 12 months. Wedge amounts were prescribed based on symptom response to a step‐down test. A control group of 19 patients wearing prescribed neutral orthoses were also captured at 0 and 12 months. The gait of the intervention group wearing neutral orthoses was additionally captured. Walking speed and shoes were controlled. Analyses of variance were conducted to examine for group‐by‐time (between the groups in their prescribed orthoses) and condition‐by‐time (within the intervention group) interactions, main effects, and simple effects. We observed increased knee adduction moments and frontal plane motion over time in the control group but not the intervention group. Further, within the intervention group, the mechanical effectiveness of the lateral wedging did not decrease. In patients with medial knee osteoarthritis, the effects of lateral foot wedging on pathomechanics associated with medial knee osteoarthritis were favorable and sustained over time. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 659–664, 2013     

人工全膝关节置换术中联合股骨外髁滑移截骨术矫正股骨外弓畸形的疗效分析

目的探讨人工全膝关节置换术(total knee arthroplasty,TKA)中采用股骨外髁滑移截骨术(lateral condyle sliding osteotomy,LCSO)矫正股骨外弓畸形的疗效。方法回顾分析2018年7月—2020年7月TKA中采用LCSO治疗的17例伴股骨外弓畸形的骨关节炎患者临床资料。男3例,女14例;年龄58~68岁,平均63.2岁。股骨外弓畸形病因:股骨发育畸形12例,股骨骨折畸形愈合5例。膝关节骨关节炎KellgrenLawrence分级:Ⅲ级4例,Ⅳ级13例。术前生理外翻角为9.5°~12.5°,平均10.94°。病程3~25年,平均15.1年。术前及末次随访时测量股骨远端机械外侧角(mechanical lateral distal femur angle,mLDFA)、髋-膝-踝角(hip-knee-ankle angle,HKA)、机械轴偏向(mechanical axis deviation,MAD),评估关节外畸形在关节内矫正及下肢机械力线恢复情况;采用膝关节学会评分系统(KSS)膝评分和功能评分、疼痛视觉模拟评分(VAS)、膝关节活动度(range of motion,ROM)评估疗效;行膝内、外翻应力试验,X线片复查截骨片愈合情况,评估关节稳定性及LCSO的安全性。结果术后患者切口均Ⅰ期愈合,无切口感染、下肢深静脉血栓形成等术后早期并发症发生。17例患者均获随访,随访时间12~36个月,平均23.9个月。截骨片均达骨性愈合,愈合时间2~5个月,平均3.1个月。术后膝内、外翻应力试验均为阴性,未发生外侧副韧带松弛、断裂,膝关节不稳,假体松动、翻修、感染等情况。末次随访时mLDFA、HKA、MAD及膝关节ROM、VAS评分、KSS膝评分和功能评分均较术前显著改善,差异有统计学意义(P<0.05)。结论在伴有股骨外弓畸形TKA中应用LCSO疗效确切且安全,关节外畸形在关节内矫正,一次手术可同时恢复下肢机械力线和关节平衡。     

外侧半月板切除术对成人膝关节周围骨密度的影响

目的 观察外侧半月板切除术（lateral meniscectomy,LMT）对膝关节周围骨密度的影响.方法 选择术后患者128例,根据术后时间分为：0～1年组、2～4年组、5～10年组和11～17年组,设对应健侧为对照组,应用双能X线骨密度仪分别测量膝关节周围六个感兴趣区（region of interest,ROI）骨密度,并拍摄术侧膝关节计算机辅助的X线照片（computed roentgenograph,CR）.结果 0～1年组膝关节周围六个ROI骨密度均下降,R1～R4骨密度分别与对照组比较差异有统计学意义（P＜O.01）;术后2～4年组R1～R4骨密度均下降,而R5、R6骨密度有所增加,其中以R1、R3变化显著,分别与对照组比较差异有统计学意义（P＜0.01）;术后5～10年R2骨密度下降,但其余ROI骨密度增加,以外侧ROI骨密度增加明显,分别与对照组比较差异有统计学意义（P＜0.05）;术后11～17年组R1、R3骨密度下降,分别与对应健侧比较差异有统计学意义（P＜0.05）;CR片结果：部分正常,有的表现为骨小梁模糊、密度减低、可见局限性小片状骨质吸收区,有的表现为关节面内侧密度稍低、外侧密度增高,内髁小梁稀少、骨密度减低,股骨外髁骨质增生、轻度膝外翻,胫骨小梁减少、模糊但密度正常.结论 LMT术可引起膝关节周围适应性的骨重构.     

Postoperative clinical outcome between lateral retraction and eversion of patella following simultaneous bilateral total knee arthroplasty

Aims and objectiveAmong the various exposure technique used in total knee arthroplasty (TKA); the midline medial parapatellar knee approach is most commonly performed; which require mobilisation of patella for adequate surgical exposure. In this study, we compare the effect of patellar eversion with lateral retraction in simultaneous bilateral TKA to find out difference in postoperative clinical outcome between the two patellar mobilisation techniques.MethodsWe enrolled 41 patients who underwent bilateral simultaneous TKR (82 knees) from Nov 2016 to Dec 2018. During surgery patellar eversion was done in one knee and lateral retraction was done in other knee selecting them randomly to reduce the bias. During the follow up period achieving unassisted active straight leg raise (SLR), 90 flexion and complications were recorded. Measurement of Oxford knee society score (OKSS), American knee society score (AKSS), Visual Analogue Scale (VAS) score, and quadriceps strength (measured by handheld dynamometer) was done daily up to one week, 1 month, 3 months, 6 months, and 1 year postoperatively.ResultsThe time of achieving active SLR and 901 flexion postoperatively was quicker in the lateral retraction group with a statistically significant difference. VAS pain score at 1 week and 1 month along with quadriceps strength in 1-month had statistically significant favourable outcomes in the lateral retraction group. Throughout the follow up lateral retraction group had better Oxford and American knee score but the difference being statistically insignificant. No significant difference was found on the complication rate.ConclusionIn comparison to lateral retraction, patellar eversion has an adverse effect in early knee functional recovery after TKA; it delays achieving active SLR, 901 flexion and has unfavourable outcome in functional scores, quadriceps strength, and postoperative pain relief. However it has minimal effects on long term functional outcomes.     

Spontaneous osteonecrosis of the lateral femoral condyle of the knee: a report of 11 cases

BACKGROUND: Spontaneous osteonecrosis (SON) of the lateral femoral condyle of the knee joint is very rare and there have been only a few articles about this condition. MATERIALS: We reviewed data for 11 patients (7 men, 4 women) with unusual SON of the lateral femoral condyle of the knee. The average age of patients at onset was 61.9 years (range 47-76 years). No patient had underlying disease or had undergone steroid therapy, although one underwent lateral meniscectomy. RESULTS: According to Aglietti's radiographic classification, three patients had stage 1 disease, two had stage 2 disease, three had stage 3 disease, one had stage 4 disease, and two had stage 5 at first examination. The average alignment of affected limbs on standing was 5.9 degrees valgus (range 0 degrees -11 degrees ). Although the osteonecrotic lesion was seen on the lateral side, the mechanical axis passed the medial compartment in three patients. Six patients were treated conservatively and the remaining five required surgery, which consisted of lateral unicompartmental knee arthroplasties. CONCLUSION: The pathology of the necrosis of the lateral femoral condyle was considered to be different from that of the medial femoral condyle regarding clinical features, limb alignment, and radiographic findings.     

关节镜下外侧支持带松解治疗髌骨外侧高压综合征

目的探讨关节镜下外侧支持带松解治疗髌骨外侧高压综合征的效果和临床意义.方法采用关节镜下外侧支持带松解术治疗39例(51膝)髌骨外侧高压综合征.男1例(1膝),女38例(50膝);单膝27例,双膝12例;平均年龄49.6岁(28～71岁).临床症状以髌股关节钝痛为特点,疼痛位置不易确定,髌股关节负荷过度的活动会使疼痛加重.物理检查见Q角增大(＞20°)45膝,髌软骨外侧小面抠触痛50膝,外侧支持带压痛39膝,被动髌骨倾斜试验阳性51膝,内外侧滑动试验阳性49膝,压髌试验阳性51膝.X线检查轴位片见髌股对合角异常32膝.术中在关节镜监视下,用射频汽化钩刀松解外侧支持带,必要时可向近端扩大松解范围,切断部分股外侧肌,达到完全松解.结果术后所有病例均得到随访,平均随访14.5个月(3～26个月).疗效评定参照改良Lysholm评分标准,优37膝,良12膝,可2膝.Lysholm评分从术前平均(62.04±5.98)分(49～75分)提高到术后平均(93.71±3.55)分(86～100分),有显著性差异(t=6.63,P＜0.001).髌股对合角异常的32膝中术后有30膝髌股对合角恢复正常(94%).术后5膝有血肿形成(10%).结论关节镜下外侧支持带松解是一种微创的软组织平衡手术,能够有效地缓解髌骨外侧高压综合征引起的髌股关节疼痛,且并发症较少.