摘要
目的探讨关节镜下外侧支持带松解、内侧紧缩与髌股韧带重建在治疗复发性髌骨脱位中的临床疗效。方法笔者自2011-05—2014-05诊治32例复发性髌骨脱位。术前均未行手术治疗,常规测量Q角和CT片中TT-TG值。比较手术前后Lysholm和IKDC评分。结果所有患者获得平均18（13~30）个月随访,无一例出现髌骨脱位复发,术后切口均一期愈合。术后Lysholm膝关节功能综合评分为（94.23±8.38）分,术前为（48.25±6.92）分,手术前后Lysholm评分比较差异有统计学意义（t=36.80,P〈0.001）;术后IKDC膝关节主观功能评分为（93.20±5.33）分,与术前（35.57±5.10）分比较差异有统计学意义（t=47.23,P〈0.001）。结论关节镜下外侧支持带松解、内侧紧缩与髌股韧带重建治疗复发性髌骨脱位疗效确切,操作简便,可早期进行功能锻炼,有利于膝关节功能的恢复,值得临床推广。
Objective To explore the clinical results of lateral retinacular release and medial retinacular tightening plus medial patellofemoral ligament reconstruction in the treatment of recurrent patellar dislocation. Methods From May 2011 to May 2014, 32 patients with recurrent patella dislocation were treated by lateral retinacular release and medial retinaeular tightening plus medial patellofemoral ligament reconstruction who had not received any treatment before surgery. Q-angles and ＇IT-TG values in 32 patients were routinely measured before surgery . The scores of Lysholm and IKDC before surgery were compared with that of Lysholm and IKDC after surgery. Results All the patients were followed up for an average time of 18 months （range, 13 to 30 months）. There were no recurrence of dislocation during follow-up and all incisions healed by first intention. The Lysholm knee scores were improved from 48.25±6.92 preoperatively to 94.23±8.38 postoperatively, showing significant difference （t =36.80, P =0.000）. Meanwhile IKDC subjective knee scores were also improved from 35.57±5.10 preoperatively to 93,20±5.33 postoperatively, showing significant difference （t =47.23, P =0.000）. Conclusion It is effective and convenient to treat recurrent patellar dislocation by way of arthroseopie lateral retinacular release and medial retinacular tightening plus medial patellofemoral ligament reconstruction and the patient can take early funetional training to restore knee joint function to the greatest extent. This kind of operation method is worthy of clinical promotion.
出处
《中国骨与关节损伤杂志》
2016年第6期602-605,共4页
Chinese Journal of Bone and Joint Injury
关键词
髌股韧带
复发性髌骨脱位
关节镜
内外侧支持带
Medial patellofemoral ligament
Recurrent patellar dislocation
Arthroscope
Medial and lateral retinacular
