摘要
目的 对比观察单束等长重建和双束解削重建内侧髌股韧带治疗髌骨脱位的临床效果.方法 回顾性分析自2004年8月至2008年10月行内侧髌股韧带重建治疗的60例（72膝）陈旧性髌骨脱位患者的临床资料,其中单束等长重建组22例（27膝）,双束解剖重建组38例（45膝）.术后手法检查髌骨稳定性,记录再脱位的病例数,CT测量髌骨外移度及髌骨倾斜角并以Kujala和主观问卷评分进行膝关节功能评估.结果 所有患者均随访12个月以上,无再脱位病例.（1）髌骨不稳发生率,术后单束重建组18.5%,双束重建组2.2%,差异具有统计学意义（P＜0.05）.（2）术后两组髌骨倾斜角和髌骨外移率均恢复至正常范围,差异无统计学意义（P＞0.05）.（3）Kujala评分,单束组术前59±9,术后87±4;双束组术前62±9,术后94±6,差异具有统计学意义（P＜0.05）.（4）术后主观问卷：单束重建优良率85.2%,双束重建组97.8%,差异具有统计学意义（P＜0.05）.结论 单、双束重建内侧髌股韧带均明显恢复髌骨稳定性,提高膝关节功能,但临床评价双束重建优于单束重建.
Objective To compare the clinical results of single-stranded isometric with double-stranded anatomic reconstruction of medial patellofemoral ligament （MPFL） for recurrent patellar dislocation. Methods Retrospective analysis of 60 consecutive patients （72 knees） with recurrent patellar dislocation undewent medial patellofemoral ligament reconstruction between August 2004 and October 2008,22 cases （27 knees） with single-stranded isometric reconstruction, 38 cases （45 knees） with doublestranded anatomic reconstruction. Postoperatively patellar stability was examined, and recurrent rate was recorded. Patellar lateral shift ratio and tilt were measured on CT scans. Knee function was evaluated with subjective questionnaire and the Kujala score. Results All patients were followed up for more than 12months without recurrent redislocation. （ 1 ） Recurrent instability rate was 18.5% in single-stranded group and 2.2% in double-stranded group, with statistical difference（P〈0.05）. （2） The patellar tilt and lateral shift ratio returned to normal, without statistical difference between groups （ P〉 0.05 ）. （3） The Kujala score were 59 ± 9 and 62 ± 9 preoperatively and 87 ± 4 and 94 ± 6 postoperatively in single- and doublestranded group, with statistical difference （ P〈 0.05 ）. （4） The excellect rate was 85.2% in single-stranded group, 97.8% in double-stranded group, with statistical difference （ P〈 0.05 ）. Conclution Both reconstruction can improve patellar stability and knee function significantly, with double-stranded anatomic reconstruction better in clinic evaluation.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2010年第12期891-895,共5页
Chinese Journal of Surgery
关键词
髌韧带
内侧副韧带
膝
内侧髌股韧带
等长重建
解剖重建
Patellar ligament
Medial collateral ligament, knee
Medial patellofemoral ligament
Isometric reconstruction
Anatomical reconstruction
