双缝合锚钉技术双束解剖重建内侧髌股韧带治疗青少年髌股关节不稳定

发布时间：2018-07-17 03:31

【摘要】：目的:探讨双缝合锚钉技术双束解剖重建内侧髌股韧带治疗青少年髌股关节不稳定的临床疗效。方法:2013年1月至2014年12月对25例青少年髌股关节不稳定患者行双缝合锚钉技术双束解剖重建内侧髌股韧带。髌骨侧采用2枚带线锚钉固定移植物,同时行髌骨侧止点加强缝合,关节镜下调节张力后采用界面挤压螺钉固定移植物于股骨隧道。术后随访,内容包括患者满意度、髌骨外推恐惧试验、再脱位率、CT评价骨道位置及髌骨倾斜角,采用Lysholm,Tegner和Kujala评分评价患侧膝关节功能。结果:25例患者均得到随访,随访20~40(平均24)个月。髌骨恐惧试验均为阴性,无1例感染、再脱位及髌骨骨折。CT显示重建骨隧道位置良好,髌骨倾斜角术前为21.6°±2.3°,术后为10.5°±1.6°;Lysholm评分术前为51.7±5.3,术后为93.8±6.5;Tegner评分术前为4.1±1.1,术后为5.5±0.6;Kujala主观评分术前为53.5±6.4,术后为94.6±4.3,差异均有统计学意义(P0.05)。结论:双缝合锚钉技术双束解剖重建内侧髌股韧带治疗青少年髌股关节不稳定是一种安全、有效和微创的手术方法。
[Abstract]:Objective: to investigate the clinical effect of double suture anchor nail technique for reconstruction of medial patellofemoral ligament in juvenile patellofemoral joint instability. Methods: from January 2013 to December 2014, 25 young patients with unstable patellofemoral joint underwent double suture Anchor technique to reconstruct medial patellofemoral ligament. The patellar side was fixed with two wire anchor nails, and the patellar side was sutured with the side of the patella. After adjusting the tension under arthroscopy, the graft was fixed with interfacial compression screw in the femoral tunnel. Postoperative follow-up included patient satisfaction, patellar extrapolation fear test, redislocation rate and CT evaluation of the location of the osseous canal and patellar obliquity angle. Lysholm Tegner and Kujala scores were used to evaluate the knee joint function of the affected side. Results all 25 patients were followed up for 20 to 40 months (mean 24 months). The fear test of patella was negative, no infection was found in all cases, redislocation and patellar fracture. Ct showed that the reconstructed bone tunnel was in good position. The slope angle of patella was 21.6 掳卤2.3 掳before operation, 10.5 掳卤1.6 掳after operation, 51.7 卤5.3 before operation, 93.8 卤6.5 Tegner before operation, 5.5 卤0.6 Kujala subjective score before operation and 94.6 卤4.3 after operation (P0.05). Conclusion: double suture anchor nail technique is a safe, effective and minimally invasive surgical method for the treatment of juvenile patellofemoral joint instability with double bundle anatomical reconstruction of medial patellofemoral ligament.
【作者单位】：中南大学湘雅二医院骨科;
【基金】：湖南省发展和改革委员会科研项目(2014658)~~
【分类号】：R687

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