关节镜下聚乙二醇缝线重建内侧髌股韧带联合内侧支持带紧缩术治疗中青年急性髌骨脱位：至少 2 年随访结果
Arthroscopic medial patellofemoral ligament reconstruction with polyethylene suture combined with medial retinaculum plication for the treatment of acute patellar dislocation in young and middle-aged patients with a follow-up of at least 2 years.
机构信息
Department of Joint and Sports Injuries, Zhengzhou Central Hospital Affiliated Zhengzhou University, Zhengzhou, Henan, 450000, China.
Department of Sports Medicine, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China.
出版信息
BMC Musculoskelet Disord. 2024 Jul 25;25(1):581. doi: 10.1186/s12891-024-07664-y.
PURPOSE
The purpose of this study was to propose a surgical technique for arthroscopic medial patellofemoral ligament (MPFL) reconstruction with polyethylene suture combined with medial retinaculum plication and to evaluate the efficacy of this surgical technique in the treatment of acute patellar dislocation.
METHODS
Clinical data of patients with acute patellar dislocations treated with arthroscopic MPFL reconstruction with polyethylene tape (FiberTape) combined with medial support band compression were analyzed retrospectively from January 2018 to January 2021. The mean age of the patients was 25.15 ± 4.66 years; the mean follow-up time was 27.5 (24-36) months. Clinical evaluation consisted of apprehension test results, patellar extrapolation test results, Lysholm score, Kujala score, and IKDC score, the Patellar lateral shift distance and patellar tilt angle (PTA) measured by CT scan.
RESULTS
All patients had no recurrent patellar dislocation or subluxation after surgery, and the apprehension test was negative. In all patients, the Kujala score (36.0 ± 9.9 vs. 98.2 ± 3.1), the IKDC score (48.6 ± 7.0 vs. 90.6 ± 4.4) and the Lysholm score (32.8 ± 10.4 vs. 96.7 ± 3.1) had improved at the 24-month follow up (P < 0.05). In addition, PTA was significantly lower at the 12-month follow-up and 24-giving-month follow-up compared to the preoperative period (P < 0.05, Table 2). The patellar lateral shift distance decreased from 14.94 ± 6.11 mm preoperatively to 3.00 ± 1.40 mm (12-month follow up) and 3.26 ± 1.37 mm (24-month follow up), respectively.
CONCLUSION
Arthroscopic MPFL reconstruction with polyethylene suture combined with medial retinaculum plication is a safe and reliable surgical technique for the treatment of acute patellar dislocation in young and middle-aged patients.
LEVEL OF EVIDENCE
Level III, Therapeutic Study.
目的
本研究旨在提出一种关节镜下内侧髌股韧带（MPFL）重建的手术技术，采用聚乙烯缝线结合内侧支持带紧缩，并评估该手术技术治疗急性髌骨脱位的疗效。
方法
回顾性分析 2018 年 1 月至 2021 年 1 月采用关节镜下聚乙烯带（FiberTape）联合内侧支撑带压缩重建 MPFL 治疗急性髌骨脱位患者的临床资料。患者平均年龄 25.15±4.66 岁；平均随访时间 27.5（24-36）个月。临床评估包括恐惧试验结果、髌骨外移试验结果、Lysholm 评分、Kujala 评分和 IKDC 评分，CT 扫描测量髌骨外侧移位距离和髌骨倾斜角（PTA）。
结果
所有患者术后均无髌骨再脱位或半脱位，恐惧试验阴性。所有患者的 Kujala 评分（36.0±9.9 分比 98.2±3.1 分）、IKDC 评分（48.6±7.0 分比 90.6±4.4 分）和 Lysholm 评分（32.8±10.4 分比 96.7±3.1 分）在 24 个月随访时均有改善（P<0.05）。此外，与术前相比，12 个月和 24 个月随访时 PTA 明显降低（P<0.05，表 2）。髌骨外侧移位距离从术前的 14.94±6.11mm 减少至 12 个月随访时的 3.00±1.40mm 和 24 个月随访时的 3.26±1.37mm。
结论
关节镜下聚乙烯缝线结合内侧支持带紧缩重建 MPFL 是治疗中青年急性髌骨脱位安全可靠的手术方法。
证据水平
III 级，治疗性研究。
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