摘要
目的探讨膝关节镜下髌骨成形、外侧支持带松解及髌周去神经化治疗中、重度髌股关节炎的临床疗效。方法采用回顾性病例对照研究分析2013年3月-2015年3月收治的80例中、重度髌股关节炎患者临床资料。根据治疗方法不同分为两组：A组40例，OuterbridgeⅢ级22例，Ⅳ级18例，行单纯关节镜清理术；B组40例，Outerbridgem级22例，Ⅳ级18例，关节镜下清理同时行髌骨成形、外侧支持带松解及应用射频髌周去神经化。比较两组术前及术后Kujula评分及Lysholm评分，评估髌股关节功能。术后3个月屈膝30。摄髌骨轴位X线片，测量外侧髌股角，评估髌股关节功能改善情况。结果80例患者获随访13～36个月，平均19．8个月。术后两组髌股关节功能评分均得到不同程度改善。Ⅲ级髌股关节炎患者，B组术后3个月、末次随访时Kujula评分[（85．1±6．8）分、（86．84-4．6）分]和Lysholm评分[（88．1±1．8）分、（88．4±2．3）分]均高于A组[（78．1±5．7）分、（78．3±5．3）分和（82．4±2．8）分、（82．5±2．5）分]（P〈0．05）；组内术后3个月及末次随访时Kujula评分、Lysholm评分均较术前提高（P〈0．05）；根据Lysholm评分，B组术后优良率（86％）高于A组（55％）（P〈0．05）。1V级髌股关节炎患者，B组术后3个月、末次随访时Kujula评分[（72．3±5．3）分、（72．7±3．6）分]及Lysholm评分[（75．1±1．9）分、（75．3±2．3）分]均高于A组[（70．8±5．2）分、（71．1±4．2）分和（73．4±2．8）分、（73．6±2．5）分]，但差异无统计学意义（P〉0．05）；组内术后3个月及末次随访时Kujula评分、Lysholm评分虽较术前提高，但差异无统计学意义（P〉0．05）；根据Lysholm评分，虽然B组术后优良率（33％）高于A组（28％），但差异无统计学意义（P〉0．05）。无论OuterbridgeⅢ级还是Ⅳ级髌股关节炎患者，A�
Objective To investigate the clinical effects of arthroscopic patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation for treatment of moderate and severe patellofemoral osteoarthritis. Methods A retrospective case-control study was done on 80 patients with moderate to severe patellofemoral osteoarthritis who were treated in our hospital between March 2013 and March 2015. According to treatment methods, the patients were divided into two groups： Group A including 40 cases （22 cases of Outerbridge grade m degree and 18 cases of Outerbridge grade IV ） undergone arthroscopic debridement, and Group B including 40 cases （22 cases of Outerbridge grade m degree and 18 cases of Outerbridge grade IV ） undergone arthroscopic patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation. The Kujula scores and Lysholm scores of the patellofemoral joint were compared between the two groups before and after operation. The lateral patellofemoral angle was measured according to patellar axial X-ray performed 3 months after operation to evaluate patellofemoral joint function. Results All patients were followed up for 13-36 months （average 19.8 months）. The patellofemoral joint scores of the two groups was increased at different degrees after operation. In moderate patellofemoral osteoarthritis patients, at 3 months after operation and the last follow-up of Group B, Kujula scores [ （ 85.1 ±6.8 ） points, （ 86.8 ± 4.6） points I and Lysholm scores [ （88. 1 ± 1.8） points, （ 88.4 ± 2.3 ） points were higher than that of Group A I （78.1 ± 5.7） points, （78.3-5.3）points,（82.4 ---2.9）points, and （82.5 ±2.5）points] （P〈0.05）. In each group, the Kujula scores and Lysholm scores at 3 months after operation and the last follow-up were improved to be higher than p, reoperation （ P 〈 0.05 ） , with insignificant statistical difference between the two groups （P 〉 0.05 ）. According to the Lysholm scores, the
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2017年第8期743-749,共7页
Chinese Journal of Trauma
基金
宁波市医学科技计划项目（2014A08）
关键词
关节炎
髌股疼痛综合征
关节镜
Arthritis
Patellofemoral pain syndrome
Arthroscopies
