关节镜下外侧支持带松解内侧髌股韧带重建治疗复发性髌股关节脱位

doi:10.13418/j.issn.1001-165x.2017.01.021

中国临床解剖学杂志 ›› 2017, Vol. 35 ›› Issue (1): 102-105.doi: 10.13418/j.issn.1001-165x.2017.01.021

关节镜下外侧支持带松解内侧髌股韧带重建治疗复发性髌股关节脱位

黄媛霞^1,2，　段永壮¹，　王利民¹，　徐海斌²

1.郑州大学第一附属医院，郑州 450003； 2.新乡医学院第一附属医院骨科，河南卫辉 453100

收稿日期:2016-06-24 出版日期:2017-01-25 发布日期:2017-02-22
通讯作者: 王利民，教授，主任医师，博士生导师，E-mail: gu2keo@126.com
作者简介:黄媛霞（1975-），女，河南项城市人，副教授，副主任医师，硕士，主要从事骨科关节、关节镜、创伤及脊柱疾病的外科治疗，Tel：（0373）4402409，E-mail：13937354075@139.com

Curative effect of recurrent patellar dislocation through arthroscopic lateral retinacular release combined with medial patellofemoral ligament reconstruction

HUANG Yuan-xia^1,2, DUAN Yong-zhuang¹, WANG Li-min¹, XU Hai-bin²

1. The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China; 2. The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan 453100, China

Received:2016-06-24 Online:2017-01-25 Published:2017-02-22
Contact: WANG Li-min, E-mail:gu2keo@126.com

摘要/Abstract

摘要：

目的　探讨关节镜辅助下外侧支持带松解联合内侧髌股韧带（medial patellofemoral ligament，MPFL）重建手术治疗复发性髌骨脱位的临床效果。方法　对我院2012年1月-2015年1月收治的19例复发性髌骨脱位患者，采取关节镜辅助下行外侧支持带松解、内侧髌股韧带重建联合手术。术后定期随访，记录术前和术后影像学结果、Lysholm 膝关节功能综合评分和 Kujala 髌股关节评分，观察重建韧带长度变化。结果　19例均获随访，时间( 25.7±8. 56) 月（12~48月），术后无髌骨再脱位及恐惧征，无髌股关节疼痛加重，X线显示Q角在正常范围，膝关节CT（屈膝45°）显示患者髌骨外侧关节面张开角从术前平均（-1.2±6.8)°（-16°~8°）提高至术后(11.2±5.1)°（5°~18°），较术前有显著性差异（P＜0.01）。术后1年Lysholm 评分及Kujala 髌股关节评分较术前有明显改善。重建韧带长度术后即刻平均为（57.81±6.76）mm，术后1年为（58.36±6.87）mm，无明显松弛。结论　关节镜辅助下二联手术治疗复发性髌骨脱位，能有效恢复髌股关节位置和功能，预防复发，术后1年韧带无明显松弛，疗效满意。

关键词: 关节镜, 髌股关节, 脱位, 内侧髌股韧带, 重建

Abstract:

Objective 　To investigate clinical effect of arthroscopic lateral retinacular release combined with medial patellofemoral ligament reconstruction on recurrent patellar dislocation.　Methods　19 cases were admitted into our hospital for arthroscopic lateral retinacular release combined with reconstruction the medial patellofemoral ligament from January 2012 to January 2015. With Regular follow-up after surgery, we recorded preoperative and postoperative radiographic results, Lysholm knee function score and Kujala score changes of patellofemoral joint, ligament length reconstruction.　Results　19 cases were followed up for 12~48 (25.7±8.56) months after surgery, no patella redislocation and fear patellofemoral pain syndrome, no aggravation, X-ray Q angle in the normal range were found, and the knee joint CT (at 45 °) showed that patients with the lateral patellar articular surface opening angle had it increased to (11.2±5.1)°(5°~18°) postoperatively from an average (-1.2±6.8)°(-16°~8°) preoperatively, with significant difference detected (P<0.01). Lysholm scores and Kujala patellofemoral joint score one year after surgery improved significantly compared with that prior to surgery. Average length of ligament after reconstruction immediately after operation was about (57.81±6.76) mm, and it increased to about (58.36±6.87) mm one year after surgery, with no significant relaxation found.　Conclusion　Arthroscopically assisted lateral retinacular release combined with medial patellofemoral ligament reconstruction can effectively restore the position and function of the patellofemoral joint and prevent recurrence, and the curative effect is satisfactory.

Key words: Arthroscopy, Patellofemoral joint, Dislocation, Medial patellofemoral ligament, Reconstruction

黄媛霞,段永壮,王利民,徐海斌. 关节镜下外侧支持带松解内侧髌股韧带重建治疗复发性髌股关节脱位[J]. 中国临床解剖学杂志, 2017, 35(1): 102-105.

HUANG Yuan-xia, DUAN Yong-zhuang, WANG Li-min, XU Hai-bin. Curative effect of recurrent patellar dislocation through arthroscopic lateral retinacular release combined with medial patellofemoral ligament reconstruction [J]. Chinese Journal Of Clinical Anatomy, 2017, 35(1): 102-105.

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关节镜下外侧支持带松解内侧髌股韧带重建治疗复发性髌股关节脱位

Curative effect of recurrent patellar dislocation through arthroscopic lateral retinacular release combined with medial patellofemoral ligament reconstruction

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