关节镜下髌骨外侧支持带松解在治疗膝骨性关节炎中的应用体会  

Arthroscopic release of lateral patella retinaculum to osteoarthritic knee

作　　者：杨红梅[1] 任海霞[1] 赵春成 公伟[1] 张锦[1] 康彦忠 

机构地区：[1]宝鸡市中心医院骨关节科,陕西宝鸡721008

出　　处：《临床骨科杂志》2010年第1期28-30,共3页Journal of Clinical Orthopaedics

基　　金：陕西省卫生厅科研基金B类资助项目(编号:06B11)

摘　　要：目的探讨关节镜下髌骨外侧支持带松解在膝骨性关节炎治疗中的临床效果。方法对98例(143膝)骨性关节炎患者随机分组,49例采用关节镜清理联合髌骨外侧支持带松解治疗,列为治疗组;49例采用单纯关节镜清理治疗,列为对照组。术后均结合康复训练。手术前后随访均按Lysholm膝关节功能评分进行临床评价。屈膝20°位CT片测量手术前后外侧髌骨角及髌骨指数。结果所有患者关节镜下均见不同程度软骨退变。98例均获随访,时间3～38(18±2)个月。临床疗效评价:6个月治疗组术后Lysholm评分提高(30.84±5.83)分,对照组提高(16.68±5.85)分(P<0.01);治疗组外侧髌骨角及髌骨指数术后均明显改善,而对照组基本无变化。结论对膝骨性关节炎进行关节镜清理联合髌骨外侧支持带松解可以更明显地缓解或消除患者症状。Objective To approach the clinical efficacy of arthroscopic release of lateral patella retinaculum for osteoarthritic knee.Methods 143 osteoarthritic knees of 98 cases were randomly divided into experimental group and control group.The experimental group were dealt with arthroscopic debridement combined with release of lateral patella retinaculum,and the control group were dealt a simple arthroscopic debridement.All patients had rehabilitation trainings following their operations.All patients were evaluated by the Lysholm score and the lateral patellofemoral angle and patellar index of CT in 20 degrees of flexion position.Results All patients were found with varying degrees of cartilage degeneration.98 cases were followed up for 3～38（18±2） months.After 6 months,the experimental group improved the Lysholm score（30.84 ± 5.83）points,and the control group（16.68±5.85） point（P〈0.01）.Lateral patellofemoral angle and patellar index in the experimental group were significantly improved,and no change in the control group.Conclusions Treatment of arthroscopic debridement combined with release of lateral patella retinaculum can obviously ease or eliminate symptoms of osteoarthritis and postpone joint replacement.

关 键 词：骨关节炎 膝 关节镜检查 髌骨外侧支持带 

分 类 号：R684.3[医药卫生—骨科学] R687.4[医药卫生—外科学]