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采用股薄肌腱自体移植于髌骨横行钻孔处重建髌股内侧韧带。

Reconstruction of the medial patellofemoral ligament with gracilis tendon autograft in transverse patellar drill holes.

作者信息

Christiansen Svend Erik, Jacobsen Bent W, Lund Bent, Lind Martin

机构信息

Division of Sportstrauma, Orthopaedic Department, Arhus University Hospital, Arhus, Denmark.

出版信息

Arthroscopy. 2008 Jan;24(1):82-7. doi: 10.1016/j.arthro.2007.08.005. Epub 2007 Nov 5.

Abstract

PURPOSE

We present clinical results in a case series of 44 patients with medial patellofemoral ligament (MPFL) reconstruction with 12 to 32 months' follow-up.

METHODS

Reconstruction was performed via gracilis tendon autograft looped through 2 transverse 4.5-mm drill holes in the patella and fixed at the natural MPFL insertion site on the medial femoral condyle with an interference screw. At follow-up, Kujala scores, Knee Injury and Osteoarthritis Outcome Scores, objective knee function, complications, and reoperations were assessed.

RESULTS

Only 1 patella redislocation was observed. Subluxation occurred in 3 patients, whereas 4 patients had chronic pain at follow-up, all of whom had cartilage injury at surgery. The Kujala knee function score improved overall from 46 points (range, 12 to 67 points) to 84 points (range, 62 to 100 points) at follow-up.

CONCLUSIONS

MPFL reconstruction with double transverse patella drill holes and a gracilis tendon graft provides good postoperative patellar stability. Postoperative pain seems to be related to the degree of patellofemoral injury found at surgery.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

摘要

目的

我们展示了44例接受髌股内侧韧带(MPFL)重建患者的临床结果,随访时间为12至32个月。

方法

通过自体股薄肌腱重建,将肌腱穿过髌骨上两个4.5毫米的横向钻孔,并使用挤压螺钉固定于股骨内侧髁的MPFL天然附着点。随访时,评估Kujala评分、膝关节损伤和骨关节炎疗效评分、客观膝关节功能、并发症及再次手术情况。

结果

仅观察到1例髌骨再脱位。3例患者出现半脱位,4例患者在随访时有慢性疼痛,所有这些患者在手术时均有软骨损伤。随访时,Kujala膝关节功能评分总体从46分(范围12至67分)提高到84分(范围62至100分)。

结论

采用双横向髌骨钻孔和股薄肌腱移植进行MPFL重建可提供良好的术后髌骨稳定性。术后疼痛似乎与手术时发现的髌股损伤程度有关。

证据级别

IV级,治疗性病例系列。

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