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关节镜下髌骨成形及髌周去神经化治疗髌股关节炎
Hits: 2362   Download times: 1940   Received:October 31, 2014    
作者Author单位UnitE-Mail
肇刚 ZHAO Gang 解放军总医院骨科, 北京 100853
北京军区联勤部第261医院, 北京 100294
Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China  
刘玉杰 LIU Yu-jie 解放军总医院骨科, 北京 100853 Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China liuyujie301@163.com 
袁邦拓 YUAN Bang-tuo 解放军总医院骨科, 北京 100853 Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China  
申学振 SHEN Xue-zhen 解放军总医院骨科, 北京 100853 Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China  
曲峰 QU Feng 解放军总医院骨科, 北京 100853 Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China  
王江涛 WANG Jiang-tao 解放军总医院骨科, 北京 100853 Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China  
齐玮 QI Wei 解放军总医院骨科, 北京 100853 Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China  
朱娟丽 ZHU Juan-li 解放军总医院骨科, 北京 100853 Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China  
刘洋 LIU Yang 解放军总医院骨科, 北京 100853 Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China  
期刊信息:《中国骨伤》2015年28卷,第6期,第542-546页
DOI:10.3969/j.issn.1003-0034.2015.06.015


目的:探讨关节镜下髌骨成形及髌周去神经化治疗髌股关节炎的手术方法和临床疗效。

方法:自2011年9月至2013年3月收治髌股关节炎患者156例, 其中男62例, 女94例;年龄45~61岁, 平均52岁。临床表现为膝关节反复肿胀、疼痛, 上下楼、蹲下起立时疼痛加重。采用关节镜下髌骨成形及髌周去神经化治疗。手术前后采用Lysholm评分及Kujala评分对疗效进行评估, 并将软骨损伤程度进行分级后评估疗效。

结果:术后149例获得随访, 时间10~18个月, 平均(14.8±3.5)个月, 切口均愈合良好, 未见并发症。Lysholm评分由术前73.29±4.48提高到术后80.93±4.21,Kajala评分由术前68.34±6.22提高到术后76.48±6.54,软骨损伤Ⅰ-Ⅲ级者术后疗效较好, 软骨损伤Ⅳ级者疗效较差。

结论:关节镜下髌骨成形及髌周去神经化治疗髌股关节炎可明显缓解膝前疼痛, 改善膝关节功能, 提高生活质量, 延缓关节炎进程。
[关键词]:关节炎  膝关节  髌股疼痛综合征  关节镜
 
Arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis
Abstract:

Objective:To investigate surgical procedure and clinical effects for the treatment of patellofemoral osteoarthritis (PFOA) with arthroscopic patelloplasty and circumpatellar denervation.

Methods:Totally 156 patients with PFOA (62 males and 94 females; aged from 45 to 61 years old with an average of 52) were treated from September 2011 and March 2013. The clinical manifestations included recurrent swelling and pains on knee-joint, and aggravated pains upon going up/down-stairs, squatting-down, or standing-up. PFOAs were treated with arthroscopic patelloplasty and circumpatellar denervation. The therapeutic effects before and after surgery were evaluated by Lysholm scores and Kujala scores. The therapeutic effects were graded by classification of cartilage injury degrees.

Results:Totally 149 cases were successfully followed up for 14.8 months. The incisions were healed well and no complication were occurred. Lysholm score was improved from 73.29 preoperatively to 80.93 postoperatively , and average Kajala score from 68.34 preoperatively to 76.48 after surgery. This procedure was highly effective for patients withⅠ-Ⅲ degree cartilage injury, while not for patients with Ⅳ degree cartilage injury.

Conclusion:For PFOA patients, arthroscopic patelloplasty and circumpatellar denervation is effective for significantly relieving anterior knee pains, improving knee-joint functions and quality of life, and deferring arthritic procession.
KEYWORDS:Arthritis  Knee joint  Patellofemoral pain syndrome  Arthroscopes
 
引用本文,请按以下格式著录参考文献:
中文格式:肇刚,刘玉杰,袁邦拓,申学振,曲峰,王江涛,齐玮,朱娟丽,刘洋.关节镜下髌骨成形及髌周去神经化治疗髌股关节炎[J].中国骨伤,2015,28(6):542~546
英文格式:ZHAO Gang,LIU Yu-jie,YUAN Bang-tuo,SHEN Xue-zhen,QU Feng,WANG Jiang-tao,QI Wei,ZHU Juan-li,LIU Yang.Arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(6):542~546
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