| 股骨侧Tightrope固定重建内侧髌股韧带治疗创伤性髌骨脱位 |
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投稿时间：2017-04-02
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| 作者 | Author | 单位 | Address | E-Mail |
| 左永祥* |
ZUO Yong-xiang |
温岭市第一人民医院骨一科, 浙江 温岭 317500 |
The First Department of Orthopaedics, the First People's Hospital of Wenling, Wenling 317500, Zhejiang, China |
513168774@qq.com |
| 马子平 |
MA Zi-ping |
温岭市第一人民医院骨一科, 浙江 温岭 317500 |
The First Department of Orthopaedics, the First People's Hospital of Wenling, Wenling 317500, Zhejiang, China |
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| 期刊信息：《中国骨伤》2017年，第30卷，第11期，第1039-1042页 |
| DOI：10.3969/j.issn.1003-0034.2017.11.014 |
| 基金项目: |
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中文摘要:
目的：探讨股骨侧Tightrope锁扣带袢钢板固定重建内侧髌股韧带的临床方法和疗效。
方法：自2014年5月至2016年7月治疗9例创伤性髌骨脱位患者，男5例，女4例；年龄16~47岁，平均23.7岁。所有患者先行关节镜下清理骨软骨碎片，髌骨外侧支持带松解，然后取自体半腱肌腱重建内侧髌股韧带。髌骨端采用双隧道将半腱肌腱两尾端拉入隧道后髌骨外侧打结固定，股骨端隧道采用Tightrope（Arthrex美国）锁扣带袢钢板环套半腱肌腱环（钢板翻转后可逐渐收紧线袢并自动锁死），关节镜监视髌股关系下调整张力后固定。2例胫骨结节滑车间距（TT-TG ≥ 20 mm）加做胫骨结节内移手术。
结果：9例均获随访，时间6~23个月，平均13.6个月，所有患者在随访期内未发生髌骨再脱位。所有患者术后末次随访Kujala主观性功能评分优于术前，恢复日常生活。
结论：股骨侧Tightrope固定重建内侧髌股韧带，不仅具有经济、稳固的优点，还实现了内侧髌股韧带重建的关节镜监控下张力调节，并建议在屈膝60°行张力调节以避免重建韧带过紧。 |
| 【关键词】髌骨脱位 修复外科手术 关节镜 |
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| Reconstruction of medial patellofemoral ligament with Tightrope button fixation on the femoral side for the treatment of traumatic patellar dislocation |
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ABSTRACT
Objective: To explore the operating procedures and therapeutic effects of medial patellofemoral ligament reconstruction with Tightrope(Arthrex,FL,USA) button fixation at lateral femoral cortex.
Methods: From May 2014 to July 2016,9 patients with traumatic patellar dislocation were treated. There were 5 males and 4 females,ranging in age from 16 to 47 years old,with an average of 23.7 years old. All the patients underment arthroscopic lateral retinaculum release and joint debridement first. Then the medial patellofemoral ligament was reconstructed by using a semitendinosus autograft. The ends of semitendinosus were pulled into two patellar tunnels respectively,knotted and fixed at the lateral side of patella. The semitendinosus loops were suspended and fixed through femoral tunnel with Tightrope button. The knee was fixed to about 60 degree and the tension of MPFL was adjusted by pulling Tightrope wire under arthroscopic observation. Two patients received superomedial transfer of tibial tuberosity on account of TT-TG ≥ 20 mm.
Results: All the patients were followed up,and the duration ranged from 6 to 23 months,with an average of 13.6 months. Patellar stability was re-obtained in all patients. No dislocation re-currenced during the follow-up period. The Kujala score(scoring of patellofemoral disorders) was improved at the latest follow-up compared with that before operation. All the patients returned to routine life.
Conclusion: Reconstruction of medial patellofemoral ligament with the Tightrope button fixation on the femoral side for the treatment of traumatic patellar dislocation is effective and economic. The method make the MPFL tension adjustable during the reconstuction under arthroscopy. The MPFL tension should be adjusted at 60 degree flexion of knee in order to avoid making tension level too high. |
| KEY WORDS Patellar dislocation Reconstructive surgical procedures Arthroscopes |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 左永祥,马子平.股骨侧Tightrope固定重建内侧髌股韧带治疗创伤性髌骨脱位[J].中国骨伤,2017,30(11):1039~1042 |
| 英文格式: | ZUO Yong-xiang,MA Zi-ping.Reconstruction of medial patellofemoral ligament with Tightrope button fixation on the femoral side for the treatment of traumatic patellar dislocation[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(11):1039~1042 |
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