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KMID : 0359619920040010021
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Journal of Korean Knee Society
1992 Volume.4 No. 1 p.21 ~ p.25
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Patellofemoral Malalignment Syndrome -Distal Realignment (Modified Maquet Op)-
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Schech, Joseph M.
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Abstract
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Fortunately, most young people with patellofemoral pain respond favorable to conservative treatment, including quadriceps strengthening, anti-inflammatory medication, reassuarance and physical therapy. However after failure of cnservative
treatment
for
painful patellofemoral malalignment, we should carefully evaluate the cause of the anterior knee pain, then decided to do some surgery or not depend on the cause of the anterior knee pain.
There are soft tissue realignment surgery, such as Roux-Goldthwait, Galeazzi operation and bony surgery in distal realignment of the treatment patellofemoral malalignment. There tubercle anterization(Maquet) and anteromedialization of tibial
tubercle in
distal realignment bony surgery.
If there is severe is severe articular degeneration and with or without malalignment, a straignt forward Maquet procedure or a very steep anteromedial tibial tubercle transfer may be more appropriate when all other treatment modalities have
failed.
Lateral retinacular release may not be, by itself, an adequate procedure for patellar arthrosis alone. Lateral release should be viewed as a means of denervating a painful retinaculum, minimizing mild malalignment, and reducing a patholotgically
tilted
patella.
Maquet and Ferguson and associates have emphasized the importance of relieving stress in the degenerated patellofemoral joint by anteriorization of the tibial tubercle, and consequently, anteromedial tibial tubercle transfer may be most desirable
when
realignking the extensor mechanism of a mature patient with resistant patellofemoral pain related to subluxation, elavated Q-angle, and patellofemoral degeneration with or without abnormal patella tilt. Since most patients have significant
patellar
arthrosis by the time realignment is undertaken, anteromedial tibial tubercle transfer may be the best procedure for most patients.
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KEYWORD
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