PDF(Pubmed)
Abstract：
Isolated lateral-sided knee pain is a unique problem following total knee arthroplasty (TKA). Reported causes include soft tissue impingement against extruded cement, an overhanging tibial tray, remnant osteophytes rubbing against the iliotibial band (ITB), popliteal tendon impingement, fabella syndrome, and synovial tissue impingement in the lateral gutter. In addition, iliotibial band traction syndrome secondary to guided motion Bi-cruciate stabilizing knee arthroplasty has been recognized as a new clinical entity. Initial work up should include ruling out the most common causes of painful TKA including infection, aseptic loosening, and instability. Radiographs and CT scan are utilized to identify potential source of pain. Ultrasound evaluation (with elicited probe tenderness) can increase diagnostic accuracy. Ultrasound guided local anesthetic injections can confirm the source of pain. Anti-inflammatory medications, physical therapy with ITB stretches, and therapeutic local steroid injections are initial treatment modalities. Satisfactory resolution of symptoms may require surgical intervention directed at the specific cause and may avoid the morbidity associated with revision TKA.
摘要：
孤立的外侧膝关节疼痛是全膝关节置换术（TKA）后的一个独特问题。报告的原因包括软组织撞击挤压水泥，悬垂的胫骨托,残余骨赘与髂胫骨带（ITB）摩擦，pop肌腱撞击，Fabella综合征,滑膜组织撞击外侧沟。此外,继发于引导运动的胫骨带牵引综合征双交叉稳定膝关节置换术已被认为是一种新的临床实体。最初的工作应该包括排除疼痛性TKA的最常见原因，包括感染，无菌性松动,和不稳定性。射线照相和CT扫描用于识别潜在的疼痛源。超声评估（具有引起的探头压痛）可以提高诊断准确性。超声引导的局部麻醉注射可以确认疼痛的来源。抗炎药,ITB伸展的物理疗法，治疗性局部类固醇注射是初始治疗方式。症状的满意解决可能需要针对特定原因的手术干预，并且可以避免与翻修TKA相关的发病率。
