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关节镜下内侧髌股韧带重建和外侧支持带松解治疗复发性髌骨脱位
Hits: 2132   Download times: 452   Received:December 28, 2014    
作者Author单位UnitE-Mail
张其川 ZHANG Qi-chuan 新乡市中心医院关节外科, 河南 新乡 453000 Joint Orthopaedics Department, Xinxiang Central Hospital, Xinxiang 453000, Henan, China master-zqc@163.com 
王素芳 WANG Su-fang 新乡市中心医院关节外科, 河南 新乡 453000 Joint Orthopaedics Department, Xinxiang Central Hospital, Xinxiang 453000, Henan, China  
付新生 FU Xin-sheng 新乡市中心医院关节外科, 河南 新乡 453000 Joint Orthopaedics Department, Xinxiang Central Hospital, Xinxiang 453000, Henan, China  
期刊信息:《中国骨伤》2015年28卷,第7期,第599-602页
DOI:10.3969/j.issn.1003-0034.2015.07.004


目的:评价内侧髌股韧带重建联合外侧支持带松解治疗复发性髌骨脱位的临床效果。

方法:2011年3月至2013年6月在关节镜下进行内侧髌股韧带重建联合外侧支持带松解治疗复发性髌骨脱位15例,男5例,女10例;年龄14~32岁,平均19.4岁;髌骨脱位2次及以上。术前常规行X线、CT、MR检查了解髌股关节及内侧髌股韧带情况,关节功能Lysholm评分69.85±11.52,术中镜下查看髌股对合关系及髌骨运动轨迹。术中使用自体腘绳肌腱重建内侧髌股韧带同时关节镜下外侧支持带松解。

结果:所有患者获随访,时间12~36个月,平均27.6个月,患者无再发髌骨脱位及半脱位,伸直位及屈曲30°位恐惧试验和髌骨外移试验均为阴性,术后12个月患者完全恢复正常活动,膝关节无主观不适,术后Lysholm评分92.60±5.75,较术前提高。

结论:关节镜下内侧髌股韧带重建联合外侧支持带松解手术能有效治疗复发性髌骨脱位,缓解症状,重建髌骨稳定性。
[关键词]:髌骨脱位  关节镜  膝关节
 
Arthroscopic medial patellofemoral ligament reconstruction combined with lateral retinacular release for recurrent patellar dislocation
Abstract:

Objective: To evaluate the clinical results of the medial patellofemoral ligament (MPFL) reconstruction combined with the lateral retinacular release for the treatment of recurrent patellar dislocation.

Methods: From March 2011 to June 2013,15 patients with recurrent patellar dislocation underwent arthroscopic MPFL reconstruction combined with the lateral retinacular release. The graft was autogenous semitendinosus and semimembranosus tendon. There were 5 males and 10 females with an average age of 19.4 years old(ranged,14 to 32 years old). The patients suffered recurrent patellar dislocation at least twice preoperatively. Preoperative conventional X-ray,CT,and MR examination were used to analyze the causes of the patellofemoral joint and MPFL injury. Preoperative Lysholm score was 69.85±11.52. During operation,the arthroscopic examination was performed to evaluate the patellofemoral alignment and patellar tracking.

Results: All the patients were followed up for an average of 27.6 months (ranged,12 to 36 months) with no recurrent dislocation and sub-dislocation. All the patients showed negative apprehension test at straight and 30° flexions of knee. The range of motion of knee returned to normal level at 12 months after operation. There were no patients with subjective discomfort of knee. Postoperative Lysholm score was improved to 92.60±5.75.

Conclusion: The technique of arthroscopic MPFL reconstruction combined with the lateral retinacular release is an effective surgical procedure for the treatment of recurrent patellar dislocation,which can relieve the symptom of knee and improve the patella stability and knee function.
KEYWORDS:Patellar dislocation  Arthroscopes  Knee joint
 
引用本文,请按以下格式著录参考文献:
中文格式:张其川,王素芳,付新生.关节镜下内侧髌股韧带重建和外侧支持带松解治疗复发性髌骨脱位[J].中国骨伤,2015,28(7):599~602
英文格式:ZHANG Qi-chuan,WANG Su-fang,FU Xin-sheng.Arthroscopic medial patellofemoral ligament reconstruction combined with lateral retinacular release for recurrent patellar dislocation[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(7):599~602
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