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关节镜下内侧髌股韧带重建联合外侧支持带松解治疗复发性髌骨脱位

[Arthroscopic medial patellofemoral ligament reconstruction combined with lateral retinacular release for recurrent patellar dislocation].

作者信息

Zhang Qi-chuan, Wang Su-fang, Fu Xin-sheng

出版信息

Zhongguo Gu Shang. 2015 Jul;28(7):599-602.

Abstract

OBJECTIVE

To evaluate the clinical results of the medial patellofemoral ligament (MPFL) reconstruction combined with the lateral retinacular release for the treatment of recurrent patellar dislocation.

METHODS

From March 2011 to June 2013, 15 patients with recurrent patellar dislocation underwent arthroscopic MPFL reconstruction combined with the lateral retinacular release. The graft was autogenous semitendinosus and semimembranosus tendon. There were 5 males and 10 females with an average age of 19.4 years old (ranged,14 to 32 years old). The patients suffered recurrent patellar dislocation at least twice preoperatively. Preoperative conventional X-ray, CT, and MR examination were used to analyze the causes of the patellofemoral joint and MPFL injury. Preoperative Lysholm score was 69.85 ± 11.52. During operation, the arthroscopic examination was performed to evaluate the patellofemoral alignment and patellar tracking.

RESULTS

All the patients were followed up for an average of 27.6 months (ranged,12 to 36 months) with no recurrent dislocation and sub-dislocation. All the patients showed negative apprehension test at straight and 30 ° flexions of knee. The range of motion of knee returned to normal level at 12 months after operation. There were no patients with subjective discomfort of knee. Postoperative Lysholm score was improved to 92.60 ± 5.75.

CONCLUSION

The technique of arthroscopic MPFL reconstruction combined with the lateral retinacular release is an effective surgical procedure for the treatment of recurrent patellar dislocation, which can relieve the symptom of knee and improve the patella stability and knee function.

摘要

目的

评估内侧髌股韧带(MPFL)重建联合外侧支持带松解治疗复发性髌骨脱位的临床效果。

方法

2011年3月至2013年6月,15例复发性髌骨脱位患者接受关节镜下MPFL重建联合外侧支持带松解术。移植物采用自体半腱肌和半膜肌肌腱。其中男性5例,女性10例,平均年龄19.4岁(14至32岁)。患者术前至少有两次复发性髌骨脱位。术前采用常规X线、CT和MR检查分析髌股关节及MPFL损伤原因。术前Lysholm评分为69.85±11.52。术中进行关节镜检查以评估髌股对线和髌骨轨迹。

结果

所有患者平均随访27.6个月(12至36个月),无复发性脱位和半脱位。所有患者在膝关节伸直和屈曲30°时恐惧试验均为阴性。术后12个月膝关节活动范围恢复至正常水平。无患者有膝关节主观不适。术后Lysholm评分提高至92.60±5.75。

结论

关节镜下MPFL重建联合外侧支持带松解技术是治疗复发性髌骨脱位的有效手术方法,可缓解膝关节症状,提高髌骨稳定性和膝关节功能。

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