双束解剖重建内侧髌股韧带联合胫骨结节转移术治疗复发性髌骨脱位的临床研究  

Clinical research of double-bundle anatomical reconstruction and tibia tubercle transfer surgery for recurrent patella dislocation

作　　者：纪刚[1] 王飞[1] 董江涛[1] 陈百成[1] 王成海[1] 马龙飞[1] 周建伟[1] 

机构地区：[1]河北医科大学第三医院关节骨科,石家庄050051

出　　处：《中华关节外科杂志（电子版）》2013年第1期7-11,共5页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨双束解剖重建内侧髌股韧带联合胫骨结节转移术治疗复发性髌骨脱位的治疗方法及临床疗效。方法回顾性分析自2006年12月至2010年2月行双束解剖重建内侧髌股韧带联合胫骨结节转移术治疗治疗的19例复发性髌骨脱位患者的临床资料,其中男7例,女12例,术后手法检查髌骨稳定性,记录再脱位的病例数,CT测量髌骨外移度及髌骨倾斜角并以Kujala和Lysholm评分进行膝关节功能评估。结果患者随访时间24～36个月,平均30个月,无再脱位病例。主观症状及客观体征均有明显改善,术后Kujala主观评分、Lysholm评分分别由术前的(57.38±4.49)、(58.88±4.15)分提高到(93.63±3.86)、(94.06±4.01)分,均较术前有统计学差异(t=-37.439,P<0.01;t=-33.522,P<0.01);髌骨外移率及髌骨倾斜度分别由术前的(18.93°±3.64°)、(12.25°±1.81°)降低到(8.94°±1.84°)(6.87°±1.45°),结果恢复到正常范围均较术前有统计学差异(t=15.811,P<0.01;t=15.807,P<0.01)。结论双束解剖重建内侧髌股韧带联合胫骨结节转移术能有效的治疗复发性髌骨脱位,提高膝关节的功能。Objective To discuss the method of the double-bundle anatomical reconstruction and the tibia tubercle transfer surgery, and to evaluate its clinical results. Methods A retrospective analysis was carried out on 19 consecutive patients （seven men, 12 women）with recurrent patellar dislocation, from December 2006 to February 2010. Postoperative patellar stability was examined; the recurrent rate was recorded; lateral shift ratio of patellar and tilt-angle were measured by CT scan. Knee function was evaluated by Kujala score and Lysholm score. Results 16 patients were followed up for 30 months in average （range, 24 -36 months）without recurrent dislocation. The preoperative Kujala scores and Lysholm scores were （ 57. 38 ±4.49 ） and （ 58.88±4. 15 ） respectively; the postoperative Kujala scores and Lysholm scores were （93.63±3.86） and （94.06±4. 01 ） respectively. There was statistical difference （t = - 37. 439, P 〈 0. 01 ; t = - 33. 522, P 〈 0. 01 ）. The preoperative patellar tilt angle and lateral shift ratio were （ 18.93°± 3.64°） , （ 12. 25°± 1.8°） respectively; the postoperative patellar tilt angle and lateral shift ratio were （8.94°± 1.84°） and （6. 87°± 1.45°） respectively, which was statistically different （t=15.811, P〈0.01;t=15.807, P〈0.01）. Conclusions It is effective to treat recurrent patella dislocation by double-bundle anatomical reconstruction and the tibia tubercle transfer surgery.

关 键 词：内侧副韧带 膝 髌韧带 胫骨结节转移术 

分 类 号：R687.4[医药卫生—骨科学]