关节镜辅助下自体肌腱重建内侧髌股韧带治疗复发性髌骨脱位的疗效

发布时间：2018-03-27 04:52

本文选题：复发性髌骨脱位　切入点：关节镜　出处：《重庆医科大学学报》2015年08期

【摘要】：目的:探讨胫骨结节内移垫高截骨联合内侧髌股韧带重建和关节镜下外侧支持带松解治疗复发性髌骨脱位的疗效。方法:对28例复发性髌骨脱位患者(男3例,女25例),行胫骨结节内移垫高截骨联合内侧髌股韧带重建和关节镜下外侧支持带松解治疗,术中先在镜下检查髌骨轨迹,手术前后髌骨CT扫描测量髌股合适角、髌骨倾斜角及髌骨外移率以及Kujala、Lysholm和Tegner运动功能评分评估膝关节功能。结果:所有患者均获得随访,随访时间12~33月,平均18.5个月,最后随访时膝关节症状得到改善,CT检查髌骨适合角、髌骨倾斜角及髌骨外移率分别由术前的(33.85±4.30)°、(12.23±1.78)°、(47.7±2.61)%降低到(11.58±1.86)°、(8.35±1.52)°、(8.80±1.63)%,均有统计学差异(P=0.000);Kujala、Lysholm和Tegner运动功能评分分别由术前的(57.70±2.93)、(56.3±2.53)、(3.40±0.94)分提高到(89.90±2.87)、(91.40±2.06)、(5.20±1.07)分,均有统计学差异(P=0.000)。结论:胫骨结节内移垫高截骨联合内侧髌股韧带重建和关节镜下外侧支持带松解能有效治疗复发性髌骨脱位,改善膝关节的稳定性并避免脱位复发,利于患者膝关节功能恢复。
[Abstract]:Objective: to evaluate the efficacy of high osteotomy with medial patellofemoral ligament reconstruction and arthroscopic lateral retinaculum release in the treatment of recurrent patellar dislocation. Twenty-five female patients were treated with high osteotomy of the medial patellofemoral ligament and arthroscopic lateral retinaculum release. The patellar locus was examined under the microscope, and the patellofemoral proper angle was measured by CT scanning before and after the operation. Knee joint function was evaluated by patellar obliquity angle, patellar outward migration rate, Kujalahe Lysholm and Tegner motor function score. Results: all the patients were followed up for 1233 months with an average of 18.5 months. At the end of follow-up, the knee joint symptoms were improved and the patellar angle of inclination and the patellar outward migration rate were decreased from the preoperative patellar angle of 33.85 卤4.30 掳to 11.58 卤1.86 掳and 8.35 卤1.52 掳to 11.58 卤1.86 掳卤1.52 掳and 8.80 卤1.52 掳, respectively. The scores of Kujala Lysholm and Tegner motor function were increased from 57.70 卤2.333.53 卤3.40 卤0.94 to 89.90 卤2.871.40 卤2.06 卤5.20 卤5.20, respectively, and the scores of the patellar obliquity angle and the patellar outward migration rate were increased from 57.70 卤2.33.53 卤3.40 卤0.94 to 89.90 卤2.871.40 卤2.06 卤2.06 卤5.20 卤5.20%, respectively. Conclusion: high osteotomy combined with reconstruction of medial patellofemoral ligament and release of lateral retinaculum under arthroscopy can effectively treat recurrent patellar dislocation, improve the stability of knee joint and avoid recurrence of dislocation. It is beneficial to the recovery of knee joint function.
【作者单位】：遵义医学院附属医院关节外科;
【分类号】：R687.4

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