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关节镜辅助下解剖重建内侧髌股韧带治疗习惯性髌骨脱位
Hits: 2336   Download times: 1312   Received:December 20, 2016    
作者Author单位UnitE-Mail
余振阳 YU Zhen-yang 解放军总医院骨科, 北京 100853 Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China  
蔡谞 CAI Xu 解放军总医院骨科, 北京 100853 Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China caixu301@163.com 
谷旺 GU Wang 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》2017年30卷,第4期,第295-299页
DOI:10.3969/j.issn.1003-0034.2017.04.002


目的:观察内侧髌股韧带重建术治疗习惯性髌骨脱位的疗效。

方法:回顾性分析2009年6月至2014年12月25例习惯性髌骨脱位患者在关节镜辅助下行内侧髌股韧带重建术的临床资料,其中男10例,女15例;平均年龄18.4岁(15~25岁);术前有运动外伤史15例,慢性损伤史7例,无明显诱因3例;左膝11例,右膝14例;脱位次数3~10次。术后进行相应的功能锻炼。依据膝关节活动度、Lysholm评分、Kujala评分、Insall评定法以及髌骨恐惧试验、髌骨研磨试验对术后临床效果进行评价。

结果:25例均获得随访,时间12~48个月,平均24.8个月。术后所有患者切口愈合良好,无感染、再脱位等相关并发症。末次随访时患者膝关节活动度(122.60±5.42)°,高于术前的(105.40±5.93)°;Lysholm评分91.44±5.53,高于术前的64.12±7.49;Kujala评分92.44±2.69,高于术前的57.88±5.10;Insall评定法评定优19例,良5例,可1例。

结论:关节镜辅助下解剖重建内侧髌股韧带治疗习惯性髌骨脱位疗效确切,有助于临床症状的缓解和膝关节功能的改善。
[关键词]:髌骨脱位  关节镜  内侧韧带,膝  膝关节
 
Clinical research on the arthroscopic treatment for recurrent patellar dislocation by anatomical reconstruction of medial patellarfemoral ligament
Abstract:

Objective: To observe the therapeutic effects of arthroscopic treatment for recurrent patellar dislocation by anatomical reconstruction of medial patellarfemoral ligament.

Methods: From June 2009 to December 2014,25 patients with recurrent patellar dislocation were treated with anatomical reconstruction of medial patellarfemoral ligament surgery under arthroscopy. There were 10 males and 15 females,with an average age of 18.4 years old (ranged,15 to 25 years old). There were 15 patients who had a medical history of sports injury,7 patients had a chronic impairment history,and the other 3 patients had the symptoms without obvious predisposing causes. Fourteen patients had injuries on the right knee and 11 patients had injuries on the left knee. All the patients suffered from patellar dislocation 3 to 10 times. After operation,the exercise of knee joint were performed postoperatively. The knee range of motion,Lysholm score,Kujala score,Insall criteria,Patellar apprehension test and patellar grinding test were observed to evaluate the clinical effects.

Results: All the patients were followed up,and the duration ranged from 12 to 48 months,with an average of 24.8 months. After surgery,all the wounds were healed excellent and there were no complications like surgical incision infection or patellar redislocation. The ranges of motion was increased from preoperative (105.40±5.93)° to postoperative(122.60±5.42)°. At the latest follow-up,the Lysholm scores were increased from preoperative 64.12±7.49 to postoperative 91.44±5.53,the Kujala scores were increased from preoperative 57.88±5.10 to postoperative 92.44±2.69. According to the Insall criteria,19 patients got an excellent result,5 good and 1 fair.

Conclusion: It has a satisfactory clinical therapeutic effect on anatomical reconstruction of medial patellarfemoral ligament under arthroscopy for the treatment of recurrent patellar dislocation. It is helpful for the relief of clinical symptoms and improvement of knee joint function.
KEYWORDS:Patellar dislocation  Arthroscopes  Medial collateral ligament, knee  Knee joint
 
引用本文,请按以下格式著录参考文献:
中文格式:余振阳,蔡谞,谷旺.关节镜辅助下解剖重建内侧髌股韧带治疗习惯性髌骨脱位[J].中国骨伤,2017,30(4):295~299
英文格式:YU Zhen-yang,CAI Xu,GU Wang.Clinical research on the arthroscopic treatment for recurrent patellar dislocation by anatomical reconstruction of medial patellarfemoral ligament[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(4):295~299
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