Gadek Artur, Liszka Henryk, Ciszek Elzbieta
Szpital CenterMed w Krakowie.
Przegl Lek. 2012;69(11):1186-8.
Habitual patella dislocation and instability in the absence of effective conservative treatment requires surgery. Surgical procedures can be divided into bone, soft tissue and mixed methods. In many studies the authors emphasize the good results of Elmslie-Trillat procedure.
In 2005-2008, we operated 20 patients by modified Elmslie-Trillat procedure but 2 patients were excluded from the study because of lack of control after surgery. We modified surgical technique by type of tibial tuberosity osteotomy and reconstruction of soft tissues.
We used a subjective clinical evaluation (evaluation of Q angle, patella traction in the dynamic tests) and the Tegner and Lysholm scale. In the Tegner scale, we obtained an average improvement of 3.4 points (from 0 to 8), and in Lysholm scale average of 46.7 points (from 14 points to 65 points).
Correction of recurrent patellar dislocation and instability by a modified Elmslie-Trillat method is effective and good results are obtained. Only the appropriate selection of surgical procedure depending on the cause of disease provides a permanent cure.
习惯性髌骨脱位及不稳定在缺乏有效保守治疗时需要手术。手术方法可分为骨性、软组织及混合方法。在许多研究中,作者强调了Elmslie-Trillat手术的良好效果。
2005年至2008年,我们采用改良Elmslie-Trillat手术治疗了20例患者,但2例患者因术后缺乏随访而被排除在研究之外。我们根据胫骨结节截骨类型和软组织重建对手术技术进行了改良。
我们采用主观临床评估(评估Q角、动态试验中的髌骨牵引)以及Tegner和Lysholm评分量表。在Tegner评分量表中,我们获得了平均3.4分的改善(从0分提高到8分),在Lysholm评分量表中平均提高了46.7分(从14分提高到65分)。
采用改良Elmslie-Trillat方法纠正复发性髌骨脱位及不稳定是有效的,并取得了良好的效果。只有根据病因适当选择手术方法才能实现根治。