关节镜辅助下自体肌腱重建内侧髌股韧带治疗复发性髌骨脱位的疗效
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Medial patellofemoral ligament reconstruction with autogenous tendon under arthroscopy in the treatment of recurrent dislocation of the patella
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    摘要:

    目的:探讨胫骨结节内移垫高截骨联合内侧髌股韧带重建和关节镜下外侧支持带松解治疗复发性髌骨脱位的疗效。方法:对28例复发性髌骨脱位患者(男3例,女25例),行胫骨结节内移垫高截骨联合内侧髌股韧带重建和关节镜下外侧支持带松解治疗,术中先在镜下检查髌骨轨迹,手术前后髌骨CT扫描测量髌股合适角、髌骨倾斜角及髌骨外移率以及Kujala、Lysholm和Tegner运动功能评分评估膝关节功能。结果:所有患者均获得随访,随访时间12~33月,平均18.5个月,最后随访时膝关节症状得到改善,CT检查髌骨适合角、髌骨倾斜角及髌骨外移率分别由术前的(33.85±4.30)°、(12.23±1.78)°、(47.7±2.61)%降低到(11.58±1.86)°、(8.35±1.52)°、(8.80±1.63)%,均有统计学差异(P=0.000);Kujala、Lysholm和Tegner运动功能评分分别由术前的(57.70±2.93)、(56.3±2.53)、(3.40±0.94)分提高到(89.90±2.87)、(91.40±2.06)、(5.20±1.07)分,均有统计学差异(P=0.000)。结论:胫骨结节内移垫高截骨联合内侧髌股韧带重建和关节镜下外侧支持带松解能有效治疗复发性髌骨脱位,改善膝关节的稳定性并避免脱位复发,利于患者膝关节功能恢复。

    Abstract:

    Objective:To discuss the curative efficacy of tibial tubercle anteromedial transfer,medial patellofemoral ligament reconstruction and arthroscopic lateral retinaculum release in treating recurrent patella dislocation. Methods:Twenty-eight cases of recurrent patella dislocation were treated by tibial tubercle anteromedial transfer,medial patellofemoral ligament reconstruction and arthroscopic lateral retinaculum release,and patellar track of all patients were probed under arthroscopy intra-operatively. Patellar CT scanning was used to detect patellofemoral angle,tilt angle and lateral shift;pre-operation and post-operation knee joint function was assessed using Kujala,Lyshoim and Tegner scores. Results:All patients were followed for 18.5 months in average(ranged from 12 to 33 months. Knee joint symptoms improved at the last follow-up.CT scanning showed that patellofemoral angle,tilt angle and lateral shift were respectively reduced from pre-operative(33.85±4.30)°,(12.23±1.78)°,(47.70±2.61)% to post-operative(11.58±1.86)°,(8.35±1.52)°,(8.80±1.63)%,with statistically significant differences(P=0.000). Kujala,Lysholm and Tegner function scores were improved from pre-operative(57.70±2.93),(56.30±2.53),(3.40±0.94) to post-operative(89.90±2.87),(91.40±2.06),(5.20±1.07),with statistically significant differences(P=0.000). Conclusion:It is effective to treat recurrent patella dislocation by ways of tibial tubercle anteromedial transfer,medial patellofemoral ligament reconstruction and arthroscopic lateral retinaculum release. The operation aims to improve the stability of the knee and prevent recurrence,which is conducive to recovering knee function.

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仲鹤鹤,刘 毅,吴术红,孙鹏鹏,刘子铭.关节镜辅助下自体肌腱重建内侧髌股韧带治疗复发性髌骨脱位的疗效[J].重庆医科大学学报,2015,(8):1151-1155

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  • 在线发布日期: 2015-11-05
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