ABSTRACT
摘要
INTRODUCTION:chronicpatellartendonruptureisrareanditsincidenceandprevalenceareunknown.Furthermore,thedataaboutlatereconstructionofthepatellartendoninrheumatoidarthritisislimited.Suchcondition,ifnotmanagedproperly,cansubstantiallyaffectthepatient’sactivitiesofdailyliving.
引言：慢性髌骨肌腱断裂较为罕见，发病率和患病率未知，关于类风湿性关节炎患者重建髌韧带的研究较少。该病如果管理不当，可能会影响患者日常活动。
CASEPRESENTATION:Wereportacaseofchronicpatellartendonruptureina49yearsoldladywhohasbeensufferingfromrheumatoidarthritisforover20years.Shepresentedwithaninabilitytoextendtherightkneewhichstartedsuddenlyayearandahalfagowithoutanyhistoryoftrauma.SheunderwentreconstructionofthepatellartendonusingamassiveBTBallograft.Threeyearsaftersurgery,thepatienthadanactiverangeofmotionbetween?20and?andwaswalkingnormallywithoutanyexternalsupport.
病例呈现：患者，女，49岁。类风湿性关节炎20年，1年半前开始右膝无法伸展，无创伤史。借助骨-髌腱-骨同种异体移植术重建髌韧带，术后3年，患者关节主动活动度为?20-——?，可独立正常走路。
DISCUSSION:Whentheprimaryrepairofthepatellartendonisnotpossible,itisnecessarytoeitherrepairWithautologousaugmentationoruseagrafttoreconstructthetendon.Webelieveautograftsmaynotbesuitableinthepresenceofrheumatoidarthritissincethediseaseisassociatedwithexcessivelevelsofcollagenasethatcouldcontributetothedegenerationofthetendons.
讨论：如果一期修补无法治愈，则有必要进行自体移植或异体移植来重建髌韧带。我们认为，自体移植不适用于类风湿性关节炎患者，因为该病与胶原酶过多有关，胶原酶过多可能导致肌腱退化。
CONCLUSION:Latepatellartendonreconstructioninrheumatoidarthritisisachallengingprocedure,andwebelieveitisbestperformedusinganallografttoachievethedesiredout白癜风那里能治好北京治疗白癜风最好的专科医院在哪