Migliorini Filippo, Lüring Christian, Eschweiler Jörg, Baroncini Alice, Driessen Arne, Spiezia Filippo, Tingart Markus, Maffulli Nicola
Department of Orthopedics, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, Germany.
Department of Orthopedics, Orthopedic Clinic Dortmund, 44137 Dortmund, Germany.
Life (Basel). 2021 Mar 30;11(4):295. doi: 10.3390/life11040295.
Evidence concerning the role of isolated lateral retinacular release (LRR) for lateral patellar compression syndrome (LPCS) dates back at least three decades. Appropriate indications, execution and outcomes still remain unclear and controversial. The present investigation analyzed the midterm result of isolated and arthroscopic LRR for LPCS in a cohort of patients who underwent such procedure at our institution.
Patients undergoing isolated arthroscopic LRR for LPCS were identified retrospectively from our electronic database. All procedures were performed by two experienced surgeons. Patients with bony and/or soft tissues abnormalities, patellofemoral instability, moderate to severe chondral damage were not included. Patients with previous surgeries were not included, as were those who underwent combined interventions. Clinical scores and complications were recorded.
31 patients were recruited in the present investigation. The mean follow-up was 86.0 ± 22.8 months. The mean age of the patients at the index operation was 34.2 ± 13.1 years. A total 55% (17 of 31) were women, and 58% (18 of 31) had involved the right knee. The mean hospitalization length was 3.5 ± 1.4 days. At a mean follow-up of 86.0 ± 22.8 months, the numeric rating scale (NRS) was 1.2 ± 0.8, the Kujala score was 91.3 ± 11.3, the Lysholm score was 93.1 ± 15.0, and the Tegner score was 5.0 ± 1.8. At the latest follow-up, 9 of 31 (29.0%) of patients experienced compilations. One patient (3.2%) had a post-operative hemarthrosis which was managed conservatively. Six patients (19.4%) reported a persistent sensation of instability, without signs of patellar dislocation or subluxation. One patient underwent an arthroscopic meniscectomy, and another patient an anterior cruciate ligament (ACL) reconstruction.
isolated arthroscopic lateral retinacular release for lateral patellar compression syndrome is feasible and effective, achieving satisfying results at more than seven years following the procedure.
关于单纯外侧支持带松解术（LRR）在外侧髌股关节挤压综合征（LPCS）中的作用的证据至少可以追溯到三十年前。其合适的适应症、操作方法及疗效仍不明确且存在争议。本研究分析了在我院接受该手术的一组患者中，单纯关节镜下LRR治疗LPCS的中期结果。
通过电子数据库回顾性确定接受单纯关节镜下LRR治疗LPCS的患者。所有手术均由两名经验丰富的外科医生进行。排除存在骨和/或软组织异常、髌股关节不稳定、中度至重度软骨损伤的患者。排除既往有手术史的患者以及接受联合干预的患者。记录临床评分和并发症情况。
本研究共纳入31例患者。平均随访时间为86.0±22.8个月。初次手术时患者的平均年龄为34.2±13.1岁。其中55%（31例中的17例）为女性，58%（31例中的18例）累及右膝。平均住院时间为3.5±1.4天。在平均随访86.0±22.8个月时，数字评分量表（NRS）为1.2±0.8，库贾拉评分91.3±11.3，莱肖尔姆评分（Lysholm score）为93.1±15.0，特格纳评分（Tegner score）为5.0±1.8。在最近一次随访时，31例患者中有9例（29.0%）出现并发症。1例患者（3.2%）术后发生关节积血，经保守治疗。6例患者（19.4%）报告有持续的不稳定感，但无髌骨脱位或半脱位迹象。1例患者接受了关节镜下半月板切除术，另1例患者接受了前交叉韧带（ACL）重建术。
单纯关节镜下外侧支持带松解术治疗外侧髌股关节挤压综合征是可行且有效的，术后七年多可取得满意效果。
