关节镜下外侧支持带松解内侧髌股韧带重建治疗复发性髌股关节脱位

发布时间：2018-04-29 16:04

本文选题：关节镜 + 髌股关节　；参考：《中国临床解剖学杂志》2017年01期

【摘要】：目的探讨关节镜辅助下外侧支持带松解联合内侧髌股韧带(medial patellofemoral ligament,MPFL)重建手术治疗复发性髌骨脱位的临床效果。方法对我院2012年1月-2015年1月收治的19例复发性髌骨脱位患者,采取关节镜辅助下行外侧支持带松解、内侧髌股韧带重建联合手术。术后定期随访,记录术前和术后影像学结果、Lysholm膝关节功能综合评分和Kujala髌股关节评分,观察重建韧带长度变化。结果 19例均获随访,时间(25.7±8.56)月(12~48月),术后无髌骨再脱位及恐惧征,无髌股关节疼痛加重,X线显示Q角在正常范围,膝关节CT(屈膝45°)显示患者髌骨外侧关节面张开角从术前平均(-1.2±6.8)°(-16°~8°)提高至术后(11.2±5.1)°(5°~18°),较术前有显著性差异(P0.01)。术后1年Lysholm评分及Kujala髌股关节评分较术前有明显改善。重建韧带长度术后即刻平均为(57.81±6.76)mm,术后1年为(58.36±6.87)mm,无明显松弛。结论关节镜辅助下二联手术治疗复发性髌骨脱位,能有效恢复髌股关节位置和功能,预防复发,术后1年韧带无明显松弛,疗效满意。
[Abstract]:Objective to investigate the clinical effect of arthroscopic lateral retinaculum release combined with medial patellofemoral ligamentous MPFLR reconstruction in the treatment of recurrent patellar dislocation. Methods from January 2012 to January 2015, 19 patients with recurrent patellar dislocation were treated with arthroscopic assisted lateral retinaculum release and medial patellofemoral ligament reconstruction. The results of preoperative and postoperative imaging were recorded, and the Kujala patellofemoral joint score and Lysholm knee joint function score were recorded. The length of the reconstructed ligament was observed. Results all the 19 cases were followed up for 25.7 卤8.56 months from 12 to 48 months. There was no redislocation of patella and fear sign after operation, and no exacerbation of patellofemoral joint pain on X ray showed that Q angle was in normal range. Knee CTS (flexion 45 掳) showed that the opening angle of lateral articular surface of patella increased from an average of -1.2 卤6.8 掳-16 掳~ 8 掳before operation to 11.2 卤5.1 掳(5 掳~ 18 掳) after operation, which was significantly different from that before operation (P 0.01). One year after operation, Lysholm score and Kujala patellofemoral joint score were significantly improved. The average length of reconstructed ligament was 57.81 卤6.76 mm immediately after operation and 58.36 卤6.87 mm at 1 year postoperatively. Conclusion the treatment of recurrent patellar dislocation with arthroscopic double operation can effectively restore the position and function of patellofemoral joint and prevent recurrence. The ligaments have no obvious relaxation after one year and the curative effect is satisfactory.
【作者单位】：郑州大学第一附属医院;新乡医学院第一附属医院骨科;
【分类号】：R687.4

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