Satterfield William H, Johnson Darren L
Department of Orthopaedic Surgery, The University of Kentucky, Lexington, Kentucky, USA.
Arthroscopy. 2005 May;21(5):627. doi: 10.1016/j.arthro.2005.02.001.
We present a case of acute patellar dislocation in a skeletally immature patient treated with arthroscopic medial patellofemoral ligamentous complex repair using suture anchors with a horizontal mattress suture technique. Patellar dislocation is a common problem in the skeletally immature. Treatment is controversial for first-time dislocators because of the high rate of recurrent instability and functional disability in these patients. Surgical repair of the medial restraints may decrease recurrent instability, although anterior knee pain and crepitus is a common finding after open surgical techniques. Arthroscopic medial retinacular imbrication has been described for patients with persistent instability with good short-term results. Acute dislocations may cause avulsion of the medial patellofemoral ligamentous complex from the patella; this is amenable to direct primary repair to prevent recurrent instability and avoid the morbidity of open surgery. This technique recreates normal anatomy and function with minimally invasive surgery.
我们报告一例骨骼未成熟患者的急性髌骨脱位病例,采用关节镜下使用缝线锚钉及水平褥式缝合技术修复内侧髌股韧带复合体进行治疗。髌骨脱位在骨骼未成熟人群中是一个常见问题。对于首次脱位者,由于这些患者复发性不稳定和功能障碍的发生率较高,治疗存在争议。内侧稳定结构的手术修复可能会降低复发性不稳定,尽管开放性手术技术后前膝疼痛和摩擦音是常见表现。关节镜下内侧支持带叠瓦成形术已被描述用于治疗持续不稳定的患者,短期效果良好。急性脱位可能导致内侧髌股韧带复合体从髌骨撕脱;这适合直接一期修复,以防止复发性不稳定并避免开放性手术的并发症。该技术通过微创手术重建正常的解剖结构和功能。