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[髌骨内侧或外侧稳定器与髌股关节稳定关系的实验研究]

[Experimentation of the relationship between medial or lateral patellar stabilizer and patellofemoral stabilization].

作者信息

Liang Xing-Sen, Yu Zheng-Hong, Li Yi-Kai, Jiang Ying-Ping, Chen Xian-Wu, Huang Min

机构信息

Department of Rehabilitation, Guangdong No.2 People's Hospital, Guangzhou 510317, Guangdong, China;

Department of Rehabilitation, Guangdong No.2 People's Hospital, Guangzhou 510317, Guangdong, China.

出版信息

Zhongguo Gu Shang. 2017 Apr 25;30(4):364-367. doi: 10.3969/j.issn.1003-0034.2017.04.017.

Abstract

OBJECTIVE

To study the contribution of medial or lateral stabilizer to the stability of the patella, to explore the function and effect of releasing the LPR clinically and to provide a biomechanical basis for the clinical treatment of patellar instability(PI).

METHODS

The quadriceps femoris of 6 fresh human cadaver knees were loaded to simulate a normal condition of muscle strength. First the loading force was measured and recorded, which subluxated the patella with the different degrees of knee flexion. Intervention 1:released the medial patellar retinaculum(MPR) to simulate pathologic conditions, then repeated the above manipulates and recorded the loading force. Intervention 2:released the LPR furthermore to simulate clinical surgical treatment, then repeated the above manipulates and recorded the loading force.

RESULTS

After releasing the MPR, the loading force which subluxated the patella were decreased obviously, and there were significant differences between the two groups(<0.05). The above loading force was further decreased after the further release of LPR, but the difference was not significant(>0.05).

CONCLUSIONS

MPR plays an important role in maintaining the stability of the patella and in the normal trajectory of the patellofemoral joint. The attention should be paid to the repair or reconstruction of the MPR in the treatment for patella recurrent lateral dislocation subluxation. Releasing the LPR is not a best choice.

摘要

目的

研究内侧或外侧稳定结构对髌骨稳定性的贡献,探讨临床松解外侧髌股韧带(LPR)的作用及效果,为髌骨不稳定(PI)的临床治疗提供生物力学依据。

方法

对6具新鲜人尸体膝关节的股四头肌施加负荷以模拟正常肌力状态。首先测量并记录使髌骨在不同屈膝角度下发生半脱位的负荷力。干预1:松解内侧髌股韧带(MPR)以模拟病理状态,然后重复上述操作并记录负荷力。干预2:进一步松解LPR以模拟临床手术治疗,然后重复上述操作并记录负荷力。

结果

松解MPR后,使髌骨发生半脱位的负荷力明显降低,两组间差异有统计学意义(<0.05)。进一步松解LPR后,上述负荷力进一步降低,但差异无统计学意义(>0.05)。

结论

MPR在维持髌骨稳定性及髌股关节正常轨迹中起重要作用。在治疗复发性髌骨外侧脱位或半脱位时,应重视MPR的修复或重建。松解LPR并非最佳选择。

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