Wu Tianhao, Tang Shiyu, Wang Fei
Department of Orthopedics, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.
Department of Orthopedics, First Central Hospital of Baoding, Baoding, 071000, Hebei, People's Republic of China.
J Orthop Surg Res. 2017 Nov 14;12(1):173. doi: 10.1186/s13018-017-0676-y.
Anterior knee pain is one of the most common musculoskeletal complaints of young patients. We notice that some patients had normal femoral trochlear, medial and lateral patellar retinaculum, and special patellar morphology, which resulted in a series of symptoms in the flexion of the knee due to the impingement of the lateral articular surface of the patella with the femur. We firstly termed this pathologic process as lateral patellar impingement syndrome (LPIS). This ambispective cohort study was to explore the curative effect of arthroscopic lateral patelloplasty for early LPIS.
Thirty-five early LPIS patients which underwent arthroscopic lateral patelloplasty were enrolled in our study. Evaluations consisted of pre- and postoperative symptoms, physical examinations, radiographs, and questionnaires. The Lysholm score, patellar suitable angle, patellar tilt angle, and patellar lateral shift were measured with the CT scan and Merchant X-ray film. The efficacy was graded as excellent, good, fair, and poor according to the patient's subjective evaluation.
The patients were followed up for an average of 41.1 ± 18.6 months. The efficacy results were excellent in 6, good in 26, fair in 2, and poor in 1. There were statistical differences in pre- and postoperative Lysholm scores (80.66 ± 5.51 vs 81.91 ± 6.21) (P < 0.05). The pre- and postoperative congruence angle, patellar tilt angle, and patellar lateral shift were significantly different (P < 0.05).
Arthroscopic lateral patelloplasty is an effective and minimal-invasive method for patients with lateral patellar impingement syndrome.
膝前痛是年轻患者最常见的肌肉骨骼疾病之一。我们注意到一些患者的股骨滑车、髌内侧和外侧支持带正常，髌形态特殊，由于髌骨外侧关节面与股骨撞击，在膝关节屈曲时导致一系列症状。我们首次将这一病理过程称为髌骨外侧撞击综合征（LPIS）。本前瞻性队列研究旨在探讨关节镜下髌骨外侧成形术治疗早期LPIS的疗效。
35例接受关节镜下髌骨外侧成形术的早期LPIS患者纳入本研究。评估包括术前和术后症状、体格检查、X线片和问卷调查。通过CT扫描和Merchant X线片测量Lysholm评分、髌骨适合角、髌骨倾斜角和髌骨外侧移位。根据患者主观评价将疗效分为优、良、中、差。
患者平均随访41.1±18.6个月。疗效结果为优6例，良26例，中2例，差1例。术前和术后Lysholm评分有统计学差异（80.66±5.51 vs 81.91±6.21）（P<0.05）。术前和术后的适合角、髌骨倾斜角和髌骨外侧移位有显著差异（P<0.05）。
关节镜下髌骨外侧成形术是治疗髌骨外侧撞击综合征患者的一种有效且微创的方法。
