Zhou Hongxing, Li Qinzong, Zhang Baojian, Pan Deng, Lan Yubin, Wang Yongchao, Cheng Xiaohui
No.2 Department of Orthopedics, the 152nd Hospital of Chinese PLA, Pingdingshan Henan, 467000, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Jun;26(6):683-5.
To investigate the effectiveness of reconstructing medial patellofemoral ligament with hamstring tendon autografts for the treatment of recurrent patellar dislocation under arthroscopy.
Between January 2005 and January 2010, 22 cases of recurrent patellar dislocation were treated by lateral retinacular release and reconstruction of the medial patellofemoral ligament with hamstring tendon autografts under arthroscopy. There were 5 males and 17 females, aged 15-19 years (mean, 17.3 years). The average number of dislocation was 4 (range, 3-8). The main clinical symptoms were pain and swelling of knee joint, weakness in the leg, and limited range of motion (ROM). The patellar tilt test, pressing pain of patellofemoral ligament insertion, and apprehension sign showed positive results. According to International Knee Documentation Committee (IKDC) scoring criteria, the subjective IKDC score was 36.7 +/- 4.7, and the Lysholm score was 69.3 +/- 3.8. X-ray films showed that the patella inclined outwards.
All incisions healed by first intention. Twenty-two cases were followed up 18-49 months (mean, 34 months). Pain and swelling of knee joint and weakness were improved obviously. No recurrence was found during follow-up. The ROM of knee in flexion and extension was improved when compared with preoperative ROM. The subjective IKDC score was 92.4 +/- 5.3 and the Lysholm knee score was 91.7 +/- 5.2, showing significant differences when compared with preoperative scores (P < 0.05).
Reconstruction of the medial patellofemoral ligament with hamstring tendon autografts under arthroscopy is an effective method to treat recurrent patellar dislocation.
探讨关节镜下采用自体腘绳肌腱重建髌股内侧韧带治疗复发性髌骨脱位的疗效。
2005年1月至2010年1月，对22例复发性髌骨脱位患者行关节镜下外侧支持带松解及自体腘绳肌腱重建髌股内侧韧带治疗。其中男5例，女17例，年龄15 - 19岁（平均17.3岁）。平均脱位次数为4次（范围3 - 8次）。主要临床症状为膝关节疼痛、肿胀、下肢无力及活动范围受限。髌股倾斜试验、髌股韧带止点压痛及恐惧征均为阳性。根据国际膝关节文献委员会（IKDC）评分标准，主观IKDC评分为36.7±4.7，Lysholm评分为69.3±3.8。X线片显示髌骨向外倾斜。
所有切口均一期愈合。22例患者随访18 - 49个月（平均34个月）。膝关节疼痛、肿胀及无力症状明显改善。随访期间无复发。膝关节屈伸活动范围较术前改善。主观IKDC评分为92.4±5.3，Lysholm膝关节评分为91.7±5.2，与术前评分比较差异有统计学意义（P < 0.05）。
关节镜下采用自体腘绳肌腱重建髌股内侧韧带是治疗复发性髌骨脱位的有效方法。
