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双束解剖型内侧髌股韧带重建联合外侧支持带松解术可使髌骨脱位患者获得良好的疗效。

Double-bundle anatomical medial patellofemoral ligament reconstruction with lateral retinaculum plasty can lead to good outcomes in patients with patellar dislocation.

机构信息

Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2018 Sep;26(9):2743-2749. doi: 10.1007/s00167-017-4720-6. Epub 2017 Sep 20.

Abstract

PURPOSE

To evaluate the clinical outcomes of double-bundle anatomical medial patellofemoral ligament (MPFL) reconstruction combined with lateral retinaculum plasty versus isolated MPFL reconstruction for patellar dislocation.

METHODS

From 2011 to 2013, 64 patients underwent either double-bundle anatomical MPFL reconstruction combined with lateral retinaculum plasty (Group A, 32 patients), or isolated MPFL reconstruction (Group B, 32 patients). Clinical evaluations were performed 2 years post-operatively and included determination of the number of patients with patellar redislocation, the patellar tilt angle, lateral patellar shift, subjective symptoms, and functional outcomes as evaluated with the Kujala score and Lysholm score.

RESULTS

No dislocation or subluxation occurred during the 25-month follow-up. Radiographically, the patellar tilt angle was 6.0° ± 1.7° in Group A and 6.7° ± 2.0° in Group B, without a significant difference (n. s). The lateral patellar shift was 8.0 ± 2.6 mm in Group A and 8.5 ± 2.4 mm in Group B (n. s). The mean Kujala score was 91.8 ± 3.7 in Group A and 91.5 ± 3.6 in Group B post-operatively (n. s), and the mean Lysholm score was 92.5 ± 3.8 and 90.8 ± 4.9, respectively (n. s).

CONCLUSIONS

Double-bundle anatomical MPFL reconstruction with lateral retinaculum plasty is a promising procedure that provides a new option for patellar dislocation.

LEVEL OF EVIDENCE

III.

摘要

目的

评估双束解剖内侧髌股韧带(MPFL)重建联合外侧支持带松解与单纯 MPFL 重建治疗髌骨脱位的临床效果。

方法

2011 年至 2013 年,64 例患者分别接受了双束解剖 MPFL 重建联合外侧支持带松解(A 组,32 例)或单纯 MPFL 重建(B 组,32 例)。术后 2 年进行临床评估,包括髌骨再脱位患者的数量、髌骨倾斜角、外侧髌骨移位、主观症状和功能结果(采用 Kujala 评分和 Lysholm 评分进行评估)。

结果

在 25 个月的随访中,没有发生脱位或半脱位。影像学上,A 组髌骨倾斜角为 6.0°±1.7°,B 组为 6.7°±2.0°,无显著差异(n. s)。A 组外侧髌骨移位为 8.0±2.6mm,B 组为 8.5±2.4mm,无显著差异(n. s)。A 组术后 Kujala 评分为 91.8±3.7,B 组为 91.5±3.6,无显著差异(n. s)。A 组 Lysholm 评分为 92.5±3.8,B 组为 90.8±4.9,无显著差异(n. s)。

结论

双束解剖 MPFL 重建联合外侧支持带松解是一种有前途的治疗髌骨脱位的方法,为髌骨脱位的治疗提供了新的选择。

证据水平

III 级。

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