关节镜辅助下手术治疗成人习惯性髌骨脱位  

Combined Surgical Procedures Assisted with Arthroscopy to Treat the Habitual Dislocation of the Patella in Adults

作　　者：叶俊武[1] 吴青[1] 陈路[1] 夏羿凡[1] 蔚 

机构地区：[1]四川省川北医学院附属医院骨科,四川南充637000

出　　处：《实用骨科杂志》2011年第2期111-114,共4页Journal of Practical Orthopaedics

摘　　要：目的评价关节镜辅助下治疗成人(骨骺发育成熟患者)髌骨习惯性脱位的临床疗效。方法在关节镜辅助下,应用改良Maquet术及内侧髌股韧带解剖重建术治疗成年人习惯性髌骨脱位8例,年龄16～32岁,平均为21.5岁;术后通过平均20.6个月(15～28个月)的随访,了解膝关节脱位复发、Q角改变情况,并采用Lysholm评分评估患肢整体功能康复情况。结果所有病例均未发生再脱位,且疼痛均明显减轻。手术前后Q角分别为(20.6±3.5)°和(12±1.2)°(P<0.01),伸膝力线均有所改善。术前和术后Lysholm膝关节功能评分为(52.00±11.25)分和(86.06±9.62)分(P<0.05),所有患者的运动能力均较术前有一定改善。结论在关节镜辅助下手术治疗成人习惯性髌骨脱位,术后膝关节功能恢复,主客观疗效均较满意。Objective To evaluate clinical effect of combined surgical procedures assisted with arthroscopy to treat habitual dislocation of patella in adults（with matured epiphysis）.Methods eight cases with habitual dislocation of patella of knee underwent surgical procedures assisted with arthroscopy that included modified Maquet procedure and anatomic reconstruction of medial patellofemoral ligament.Mean age at surgery was 21.5 years（range from 16 years to 32 years）.Patients were reviewed at an average follow-up of 20.6 months（range 15 months to 28 months）.The rate of recurrences,the subjective symptoms and the function of the involved leg were evaluated according to the Lysholm rating scale.The change of Q angles were filled out a form.Results In all cases after operation,none showed signs of recurrence of dislocation,and anterior knee pain alleviated significantly.Radiographically,there was a statistically significant improvement in the Q angles from（20.6±3.5）° to（12±1.2）°（P〈0.01）in average,which indicated evident realignment on force line of lower extremity.The average preoperative Lysholm knee score was（52.00±11.25） and the average postoperative score was（86.06 ±9.62）（P〈0.05）.The sport ability improved in all patients.Conclusion The majority of adult patients,suffering from habitual dislocation of patella,are satisfied with their knee after surgical procedures assisted with arthroscopy on objective and subjective results of functional restoration.

关 键 词：髌骨脱位 内侧髌股韧带 关节镜 

分 类 号：R684.7[医药卫生—骨科学]