摘要
目的:探讨通过胫骨结节近端移位手术治疗重度习惯性髌骨脱位(habitual dislocation of pa-tella,HDP)的临床疗效。方法:2010年4月至2014年4月,共51例习惯性髌骨脱位患者接受手术治疗,共入选符合标准的患者28例。全部患者采用胫骨结节近端移位手术联合外侧结构松解术,其他辅助手术包括内侧髌骨股骨韧带(medial patellofemoral ligament,MPFL)重建和胫骨结节內移截骨术。术后4周、8周、1年以及此后的每年进行主客观临床评估和影像学评估。结果:全部入选患者获得2年以上随访,平均年龄为27.2±9.4岁(18至39岁),平均随访26.4±5.8个月(24至36个月)。术后及末次随访时均没有外侧再脱位。末次随访时主诉有膝关节力弱(17.2%,5/29)、髌股关节疼痛(6.9%,2/29)和关节僵硬(6.9%,2/29)。全部主观评分结果的改善均有统计学意义。结论:对于伸膝装置重度短缩的成人习惯性髌骨脱位,采用胫骨结节近端移位术可以获得满意疗效。
Objective To evaluate the clinical outcome of tibial tubercle proximalization in the treatment of patients with severe habitual dislocation of patella （HDP）. Methods Among 51 HDP patients treated surgically in our hospital between April 2010 and 2014, 28 were eligible for retrospective evaluation. All patients underwent tibial tubercle proximalization and lateral structure release. Additional surgeries included medial patellofemoral ligament （MPFL） reconstruction and tibial tubercle medialization. Radiological and subjective evaluations were performed at 4th and 8th weeks after the operation, as well as 1 year and every year afterwards. Results Twenty-eight patients,with an average age of （27.2 ＋ 9.4）（ranging from 18 to 39）were followed up for a minimum of 2 years,the mean follow-up period being （26.4 ＋ 5.8）months （ranging from 24 to 36）. It was found 17.2% （5/29） patients of quadriceps weakness, 6.9% （2/29）of patellofemoral pain and 6.9% （2/29）of stiffness. No redislocation was reported. Significant improvement was observed in all subjective evaluation scores. Conclusions For patients with severe HDP, tibiat tubercle proximalization can achieve satisfactory results.
出处
《中国运动医学杂志》
CAS
CSCD
北大核心
2017年第11期945-949,955,共6页
Chinese Journal of Sports Medicine
基金
北京市医院管理局临床医学发展专项--"扬帆"计划
北京市医院管理局临床技术创新项目(编号:XMLX201613)
关键词
习惯性髌骨脱位
成人
外侧结构松解
股外侧肌松解
胫骨结节近端移位
伸膝装置延长
habitual patellar dislocation, adult, lateral structure release, musculus vastus lateralisrelease,tibial tubercle proximalization,lengthening using apparatus of extension knee
