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采用髌旁固定缝线结扎技术重建内侧髌股韧带。

Reconstruction of the medial patellofemoral ligament with a suture-tie technique of patellar side fixation.

机构信息

Department of Orthopedic Surgery, General Hospital of People's Liberation Army, Beijing 100853, China.

出版信息

Chin Med J (Engl). 2012 Jun;125(11):1884-8.

Abstract

BACKGROUND

Medial patellofemoral ligament (MPFL) reconstruction is the preferred operative treatment for recurrent patellar dislocation. The purpose of this study was to report a novel suture-tie technique of patellar side fixation in medial patellofemoral ligament reconstruction for recurrent patellar dislocation, and to evaluate the intermediate-term results.

METHODS

We retrospectively reviewed the results of 22 MPFL reconstructions in 21 patients (6 male and 15 female) with a suture-tie technique performed by a single surgeon between March 2004 and July 2009. All patients had been diagnosed with recurrent patellar dislocation. Outcomes were assessed preoperatively and postoperatively by physical and radiographic examination as well as with Kujala and Lysholm scores.

RESULTS

At the mean follow-up month 37.5 (range: 24 - 56 months), there was no graft failure. Primary healing was achieved in all cases. At the final follow-up, the mean Kujala score improved from 53.9 (range: 46 - 62 points) to 84.1 (range: 78 - 90 points) postoperatively (P < 0.05), and the mean Lysholm score improved from 47.2 points (range: 37 - 57 points) to 82.8 points (range: 76 - 89 points) postoperatively (P < 0.05). To date, no patients have reported redislocation or subluxation; however, there is one patient with a positive apprehension test.

CONCLUSION

A suture-tie technique in medial patellofemoral ligament reconstruction can restore patella stability without significant complication.

摘要

背景

内侧髌股韧带(MPFL)重建术是复发性髌骨脱位的首选手术治疗方法。本研究旨在报告一种新的髌旁固定缝线技术,用于复发性髌骨脱位的内侧髌股韧带重建,并评估其中期结果。

方法

我们回顾性分析了 2004 年 3 月至 2009 年 7 月间,由同一位外科医生采用缝线技术进行的 22 例 MPFL 重建的结果,共有 21 例患者(6 名男性和 15 名女性)。所有患者均被诊断为复发性髌骨脱位。通过体格检查和影像学检查以及 Kujala 和 Lysholm 评分对术前和术后的结果进行评估。

结果

在平均 37.5 个月(范围:24-56 个月)的随访中,没有发生移植物失败。所有病例均实现了一期愈合。在最终随访时,平均 Kujala 评分从术前的 53.9 分(范围:46-62 分)改善至术后的 84.1 分(范围:78-90 分)(P<0.05),平均 Lysholm 评分从术前的 47.2 分(范围:37-57 分)改善至术后的 82.8 分(范围:76-89 分)(P<0.05)。迄今为止,没有患者报告再脱位或半脱位;但有 1 例患者出现了阳性恐惧试验。

结论

内侧髌股韧带重建中的缝线技术可以恢复髌骨稳定性,且无明显并发症。

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