关节镜下微创治疗髌股关节病的疗效分析  

The effect of different orthomorphia in the treatment of patellofemoral malalignment disorders

作　　者：马丽艳[1] 陈德生[1] 张庆恩[1] 

机构地区：[1]河北省唐山市第二医院关节病科,063000

出　　处：《中国骨肿瘤骨病》2007年第5期280-282,共3页Chinse Journal Of Bone Tumor And Bone Disease

摘　　要：目的探讨关节镜结合不同矫形手术方法治疗髌股关节病的疗效及影响因素。方法82例患首先采用关节镜下手术治疗,进行关节清理,切除滑膜皱襞,修整损伤软骨及软骨成形,处理关节内其他合并损伤,然后再据病情选择其他术式:I.外侧支持带松解;Ⅱ.I+内侧支持带紧缩;Ⅲ.Ⅱ+胫骨结节内移;IV.Ⅲ+股内侧肌止点下移。术后早期在活动夹板的保护下渐进性功能练习。结果手术治疗82例,随访76例。随访6个月～4年5个月,平均1年5个月,患者术后疼痛症状明显缓解,Lysholm评分由术前平均57.8分提高到术后平均91.6分。结论髌股关节病的治疗应针对髌股关节软组织的平衡状态,骨性紊乱情况和髌股关节的吻合关系选择不同的矫形手术,才能取得理想的治疗效果。Objective To evaluate the therapeutic effectiveness and the influential factor of treatment of patellofemoral malalignment disorders, which operated with arthroscope combined with different orthomorphia. Methods Eighty-two patients received arthroscopic realignment surgery, including joint clearance, synovialis plica resection, the damaged cartilage trimming and chondroplasty. Then according to pathogenetic condition, we chooose＂ （1） releasing lateral patellar retinaculum; （2） releasing lateral patellar retinaculum and reefing medial patellar retinaculum; （3） releasing lateral patellar retinaculum and ingression of tibial tubercle; （4） releasing lateral patellar retinaculum and medial vastus muscle displacement. In the early stage after operation, patients began to do function exercises under the protection of ambulatory splint. Results Follow-up for 17 months （range 6 months to 53 months）, the pain of patient relieved manifestly. Lysholm score elevated from average 57.8 preoperatively to average 91.6 postoperatively. Conclusions The treatment of the patellofemoral malalignment disorders shoud be taken to aim firstly at the balanced condition of patellofemoral joint parenchyma, derangement condition of bone and patellofemoral joint anastomosis relationship, and then to choose different orthomorphia. Therefore it can get excellent therapeutic effectiveness.

关 键 词：关节镜 微创治疗 髌股关节 骨关节病 

分 类 号：R687.4[医药卫生—骨科学]