摘要
背景:外侧支持带松解是治疗髌股关节紊乱症首选的治疗方法,然而有些文献报道部分病例的长期随访结果并不满意。目的:分析关节镜下外侧支持带松解后的髌骨轨迹,以探讨外侧支持带松解后部分病例随访优良率下降的原因。方法:临床采集符合纳入标准的57膝(34例)样本,松解前后分别行10°,20°,30°,40°屈膝位髌股关节CT扫描,测量髌股适合角、髌骨外移角和股骨远端内侧扭转角,比较松解前后髌骨轨迹的变化。结果与结论:通过测量髌股适合角,髌骨外移角发现髌骨轨迹17膝松解后无改善,40膝明显改善。40膝的股骨远端内侧扭转角均大于9°,17膝的股骨远端内侧扭转角均小于9°。说明股骨远端内侧扭转角可能是影响外侧支持带松解后髌骨轨迹的一个重要因素。
BACKGROUND： Lateral retinacular release is the preferred treatment for patellofemoral disorders, but the long-term follow-up results reported in some literatures are not satisfied. OBJECTIVE： To analyze the improvement in patellar tracking after lateral patellar retinacular release and to determine the reasons for unsatisfactory outcomes during the follow-up. METHODS： Fifty-seven consecutive knees （34 cases）, which had undergone isolated lateral pateUar retinacular release, were included in the study. CT scans of each knee were performed before and after surgery with the knee at different degrees of dynamic flexion： 10°, 20°, 30°, and 40°. The following parameters were evaluated： femoral distal medial torsion angle, patellar congruence angle, and patellar lateral translation angle. Preoperative and postoperative measures of patellar tracking were compared. RESULTS AND CONCLUSION： There were 17 knees in which patellar tracking was not improved after surgery. Patellar tracking was improved in 40 knees after surgery. The improvement in patellar tracking did not reach the preoperative prediction when the femoral distal medial torsion angle was less than 9°. The femoral distal medial torsion angle is found to be an important factor influencing patellar maltracking recovery and may underlie unsatisfactory outcomes in some patients at a long-term follow-up.
出处
《中国组织工程研究》
CAS
CSCD
2014年第51期8330-8336,共7页
Chinese Journal of Tissue Engineering Research
