摘要
目的探讨关节镜下自体半腱肌腱重建内侧髌股韧带(MPFL)治疗复发性髌骨脱位的临床疗效。方法对21例复发性髌骨脱位的患者在关节镜下行髌骨外侧支持带松解术和自体半腱肌腱重建MPFL。术后随访髌骨脱位复发、患膝主观症状情况,术前术后根据Lysholm评分及Kujala评分评价疗效。结果本组全部患者均获随访,随访时间12~26个月,平均19.3个月。患者均无感染、血管神经损伤、皮肤坏死等并发症,随访期间无髌骨再次脱位或半脱位;髌骨倾斜试验和髌骨恐惧试验均为阴性,2例术后出现髌骨内侧牵拉不适感,经锻炼后症状消失。术后12个月随访时膝关节活动度均正常,可进行完全体育活动。术前Kujala评分为(53.71±5.81)分,Lysholm评分为(55.05±5.39)分;术后12个月随访,Kujala评分为(83.62±2.89)分,Lysholm评分为(88.33±4.55)分,术后12个月随访Lysholm、Kujala评分均较术前明显改善,差异有统计学意义(P<0.05)。术后12个月随访,优15膝,良6膝,差0膝,优良率为100%。结论关节镜下进行髌骨外侧支持带松解术和自体半腱肌腱重建MPFL能够有效治疗复发性髌骨脱位,并有利于缓解症状,改善髌骨稳定性和膝关节功能。
Objective To explore the clinical efficacy of medial patellofemoral ligament （MPFL） with autologous semitendinosus tendon assisted by arthroscope in the treatment of recurrent patella dislocation. Methods A total of 21 patients with recurrent patella dislocation all received arthroscopic lateral femoral retinaculum release and MPFL with autologons semitendinosus tendon. The recurrence of patellar dislocation and the subjective symptoms of knee were observed after operation, and the curative effect was evaluated before and after the operation according to the Lysholm score and Kujala score. Results All patients were followed-up for 12-26 months, with an average of 19.3 months. There were no complications such as infection, blood vessel and nerve injury, skin necrosis and so on. No dislocation or subluxation of the patella occurred during the follow-up period. Both the patellar tilt test and the patellar fear test were negative. 2 cases had patellar traction discomfort after the operation, and the symptoms disappeared after exercise. The knee mobility was normal and complete physical activity was performed in postoperative 12 months of follow-up. Before operation, patients had Kujala score as （53.71 ± 5.81） points and Lysholm score as （55.05 ± 5.39） points. In postoperative 12 months of follow-up, patients had Kujala score as （83.62 ± 2.89） points and Lysholm score as （88.33 ± 4.55） points. Patients had better Lysholm and Kujala score in postoperative 12 months of follow-up than that of before operation, and the difference had statistical significance （P〈0.05）. There were 15 excellent knees, 6 good knees, 0 poor knees in postoperative 12 months of follow-up, with excellent-good rate as 100%. Conclusion Arthroscopic lateral femoral retinaculum release and MPFL with autologous semitendinosus tendon is effective in treating recurrent patellar dislocation, and it is conducive to relieve symptoms and improve patellar stability and knee function.
出处
《中国实用医药》
2017年第20期16-18,共3页
China Practical Medicine
关键词
复发性髌骨脱位
关节镜
膝关节
重建
Recurrent patella dislocation
Arthroscope
Knee joint
Reconstruction
