关节镜辅助下内侧髌股韧带重建治疗复发性髌骨脱位

发布时间：2018-02-20 17:26

本文关键词： 复发性髌骨脱位内侧髌股韧带重建关节镜　出处：《宁夏医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的探讨关节镜辅助下内侧髌股韧带(MPFL)重建治疗复发性髌骨脱位的临床效果。方法选取我院2012年10月-2014年10月,全部采用关节镜辅助下MPFL重建治疗复发性髌骨脱位35例。其中男10例,女25例;年龄15~40岁,平均19.3岁。末次髌骨脱位至手术时间为1天~10个月,平均末次髌骨脱位至手术时间为5个月。有15例患者需同时行关节镜检查、软骨碎片或游离体取出,20例患者行髌骨外侧支持带松解术。结果35例随访患者中,2例失访,33例患者获全程随访,随访时间15-20个月,平均18个月,术前患者Lysholm、Kujala评分:(70.57±2.97)分、(71.78±2.32)分。全部患者术后膝关节稳定,无髌骨再脱位发生,髌骨外推试验和外推恐惧试验阴性,末次随访时Lysholm、Kujala评分:分别为(92.48±3.07)、(92.82±2.14)分,与术前比较,差异有统计学意义(P0.01)。结论MPFL重建治疗复发性髌骨脱位可以明显的改善髌骨稳定性,其疗效可靠、满意;关节镜技术辅助下微创、创伤小、并发症少、恢复快、效果良好。内侧髌股韧带重建是一项具有挑战性的外科手术方法,需要经验去避免隧道选择不佳及移植物张力不足所带来的术后并发症。关节技术的辅助可以发现其他潜在髌骨不稳的因素,可全程动态观察髌股关节屈伸活动状态,对于手术的成功有指导意义。
[Abstract]:Objective to investigate the clinical effect of arthroscopic reconstruction of medial patellofemoral ligament (MPFLL) in the treatment of recurrent patellar dislocation. 35 cases of recurrent patellar dislocation were treated with arthroscopic MPFL reconstruction, including 10 males and 25 females, aged 1540 years (mean 19.3 years). The time from the last dislocation of patella to the operation was 1 day to 10 months. The average time between the last patellar dislocation and the operation was 5 months. Results out of 35 cases, 2 cases were followed up for 33 cases, the follow-up time was 15-20 months (mean 18 months). The preoperative Lysholmma Kujala score was 71.78 卤2.32. All patients had stable knee joint, no redislocation of patella, negative extrapolation test and extrapolation fear test, and the Lysholmma Kujala score at the last follow-up was 92.48 卤3.070.82 卤2.14, respectively, compared with that before operation. Conclusion MPFL reconstruction in the treatment of recurrent patellar dislocation can obviously improve the stability of patella, and its curative effect is reliable and satisfactory. Medial patellofemoral ligament reconstruction is a challenging surgical procedure. Experience is needed to avoid postoperative complications caused by poor tunnel selection and insufficient graft tension. It is of guiding significance for the success of the operation.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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