Gerbino Peter G, Zurakowski David, Soto Ricardo, Griffin Elizabeth, Reig Thomas S, Micheli Lyle J
Monterey Joint Replacement and Sports Medicine, Monterey, CA, USA.
J Pediatr Orthop. 2008 Jan-Feb;28(1):118-23. doi: 10.1097/bpo.0b013e31815b4dcf.
Lateral patellar retinacular release has been recommended for patients with patellar tilt, tight lateral retinaculum, patellar subluxation, patellar dislocation, and patellofemoral pain. Studies of long-term outcomes after lateral release are limited, especially for differing indications.
Adolescents do well after lateral retinacular release in the 5- to 22-year time frame.
Patients having undergone lateral retinacular release between the years of 1981 and 1999 were contacted. Evaluation was by the Cincinnati and Lysholm scales and by level of satisfaction and need for reoperation.
One hundred forty knees were studied. Mean age at operation was 15.4 years (SD, 2.7 years). Average follow-up was 8.5 (SD, 4.1 years; range, 5.2-22.5 years). Twenty-five patients had needed reoperation, indicating failure of the index operation. Kaplan-Meier survivorship was 78% at 15 years. Cincinnati and Lysholm scores indicated well-functioning knees in those not requiring reoperation. Overall satisfaction improved as time from operation increased. Comparisons were made between the group requiring reoperation and those who did not. Focus was placed on knees with patellar maltracking or tilt versus patellar instability and between males and females. No differences were found among groups for reoperation rate, level of satisfaction, average Lysholm score, or average Cincinnati score. There were no differences in demographics or outcome measures between patients with patellar instability and those with tilt. Instability patients trended toward higher reoperation rates than did tilt patients, but the difference was not significant. There were no differences between males and females.
The majority of patients are satisfied with their knee 5 to 22 years after lateral patellar retinacular release and scored well on questions rating knee health and function.
对于存在髌骨倾斜、外侧支持带紧张、髌骨半脱位、髌骨脱位及髌股关节疼痛的患者，推荐行外侧髌支持带松解术。关于外侧松解术后长期疗效的研究有限，尤其是针对不同适应证的研究。
青少年在5至22年时间范围内行外侧支持带松解术后效果良好。
联系了1981年至1999年间接受外侧支持带松解术的患者。通过辛辛那提量表和Lysholm量表以及满意度和再次手术需求进行评估。
共研究了140个膝关节。手术时的平均年龄为15.4岁（标准差为2.7岁）。平均随访时间为8.5年（标准差为4.1年；范围为5.2至22.5年）。25例患者需要再次手术，提示初次手术失败。15年时的Kaplan-Meier生存率为78%。辛辛那提量表和Lysholm量表评分显示，未进行再次手术的患者膝关节功能良好。总体满意度随着术后时间的延长而提高。对需要再次手术的组和未进行再次手术的组进行了比较。重点关注存在髌骨轨迹不良或倾斜的膝关节与髌骨不稳定的膝关节之间的差异，以及男性和女性之间的差异。在再次手术率、满意度水平、平均Lysholm评分或平均辛辛那提评分方面，各组之间未发现差异。髌骨不稳定患者和倾斜患者在人口统计学或结局指标方面没有差异。不稳定患者的再次手术率有高于倾斜患者的趋势，但差异不显著。男性和女性之间没有差异。
大多数患者在外侧髌支持带松解术后5至22年对其膝关节感到满意，并且在评估膝关节健康和功能的问题上得分良好。
