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关节镜下外侧支持带松解联合外侧髌骨成形术治疗外侧压力综合征的疗效及体会。

Outcome and experience of arthroscopic lateral retinacular release combined with lateral patelloplasty in the management of excessive lateral pressure syndrome.

机构信息

Third Ward of Orthopedic Department, CR & WISCO General Hospital, Wuhan University of Science and Technology, Wuhan, 430080, China.

Department of Orthopedic Surgery, Wuhan Hanyang Hospital, Wuhan University of Science and Technology, No.53 Moshuihu Road, Hanyang District, Wuhan, Hubei Province, China.

出版信息

J Orthop Surg Res. 2021 Jan 22;16(1):80. doi: 10.1186/s13018-021-02229-4.

Abstract

BACKGROUND

Only a few studies have described the effect of full arthroscopic surgery in treatment of excessive lateral pressure syndrome (ELPS). Therefore, the purpose of this study was to assess the clinical efficacy and experience of total arthroscopic lateral retinacular (LR) release and lateral patelloplasty for the treatment of ELPS.

METHODS

A total of 73 patients (88 knees) with ELPS underwent arthroscopic LR release and lateral patelloplasty. The visual analogue scale (VAS), Kujala score, Lysholm scores, patella medial pushing distance, patellar tilt angle (PTA), and lateral patellofemoral angle (LPFA) were measured and evaluated before and after surgery.

RESULTS

Follow-up ranged from 12 to 36 months with an average of 24 ± 5.8 months. The VAS was significantly lower at the last follow-up than before surgery (P < 0.01). The patella medial pushing distance, Kujala score, Lysholm score, PTA, and LPFA were significantly higher at the last follow-up than before surgery (P < 0.01, respectively). Years and lateral patella Outerbridge classification at the last follow-up have negative correlation with Kujala score, Lysholm score, Patella medial pushing distance, PTA, and LPFA (P < 0.01, respectively) and have positive correlation with VAS (P < 0.01, respectively). Related complications were not reported.

CONCLUSIONS

Full arthroscopic LR release combined with lateral patelloplasty in the treatment of ELPS is an effective minimally invasive method, which can effectively correct anomalies of force line and skeleton of patella, relieve pain, and restore knee joint motor function with less complications.

摘要

背景

仅有少数研究描述了全关节镜手术治疗外侧压力综合征(ELPS)的效果。因此,本研究旨在评估全关节镜下外侧支持带(LR)松解联合外侧髌骨成形术治疗 ELPS 的临床疗效和经验。

方法

共 73 例(88 膝)ELPS 患者接受关节镜下 LR 松解和外侧髌骨成形术。术前和术后分别测量和评估视觉模拟评分(VAS)、Kujala 评分、Lysholm 评分、髌骨内侧推移距离、髌骨倾斜角(PTA)和外侧髌股角(LPFA)。

结果

随访时间 12-36 个月,平均 24±5.8 个月。末次随访时 VAS 明显低于术前(P<0.01)。髌骨内侧推移距离、Kujala 评分、Lysholm 评分、PTA 和 LPFA 均明显高于术前(P<0.01)。末次随访时年龄和外侧髌骨 Outerbridge 分级与 Kujala 评分、Lysholm 评分、髌骨内侧推移距离、PTA 和 LPFA 呈负相关(P<0.01),与 VAS 呈正相关(P<0.01)。未报告相关并发症。

结论

全关节镜下 LR 松解联合外侧髌骨成形术治疗 ELPS 是一种有效的微创方法,可有效纠正髌骨力线和骨骼异常,缓解疼痛,恢复膝关节运动功能,并发症少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd57/7821727/3c4dbd99ce44/13018_2021_2229_Fig1_HTML.jpg

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