髌骨外侧成形术联合外侧支持带松解术治疗髌股关节炎  

Partial lateral patellar facetectomy combined with lateral retinaculum release for treatment of patellofemoral osteoarthritis

作　　者：刘效仿[1] 周观明[1] 管明强[1] 刘礼初[1] 刘少华[1] 张念军[1] 陈金雄[1] Liu Xiaofang;Zhou Guanming;Guan Mingqiang;Liu Lichu;Liu Shaohua;Zhang Nianjun;Chen Jinxiong(Department of Orthopedics and Traumatology,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong,China)

机构地区：[1]佛山市中医院骨科,528000

出　　处：《中华创伤骨科杂志》2018年第12期1044-1048,共5页Chinese Journal of Orthopaedic Trauma

基　　金：广东省科技计划项目(20178090904002);佛山市科学技术局科技创新项目(2017AG100041).

摘　　要：目的探讨髌骨外侧成形术联合外侧支持带松解术治疗髌股关节炎的疗效。方法回顾性研究2017年6月至2018年3月在佛山市中医院接受髌骨外侧成形术联合外侧支持带松解术治疗的30例症状性髌股关节炎患者资料,男7例,女23例;年龄(56.4±9.7)岁。通过比较术前和末次随访时髌股适合角(PFCA)、髌股外侧角(LPFA)、改良Kujala评分、WOMAC骨关节炎指数、SF-12量表分别评估髌骨位置、髌股关节功能、膝关节整体功能状态、生活质量的改善情况。结果所有患者术后随访(7.6±3.4)个月(4~13个月)。PFCA从术前22.9°±7.6°改善至末次随访时12.4°±4.2°,LPFA从术前3.2°±3.7°改善至末次随访时12.9°±6.0°,改良Kujala评分从术前(17.1±9.8)分提高至末次随访时(34.3±5.7)分,WOMAC骨关节炎疼痛指数从术前14.1±5.2改善至末次随访时5.9±1.7,僵直指数从术前5.5±3.2改善至末次随访时2.7±1.2,日常功能指数从术前45.9±9.0改善至末次随访时25.2±5.4,SF-12量表从术前(31.3±5.2)分提高至末次随访时(55.7±5.0)分,以上差异均有统计学意义(P<0.05)。结论髌骨外侧成形术联合外侧支持带松解术治疗髌股关节炎既可显著减轻关节疼痛,又能最大限度保持髌骨功能,是一种微创、易于掌握且效果确切的保膝手术。Objective To evaluate the clinical outcomes of partial lateral patellar facetectomy (PLPF)combined with lateral retinaculum release (LRR)for treatment of patellofemoral osteoarthritis (PFOA).Methods From June 2017 to March 2018,30 PFOA patients underwent PLPF combined with LRR at Department of Orthopedics and Traumatology,Foshan Hospital of Traditional Chinese Medicine.They were 7 men and 23 women with an average age of 56.4±9.7 years.Their patellar position,patellofemoral joint function,overall knee function,and quality of life were assessed by comparing preoperation and last follow-up in patellofemoral congruence angle (PFCA),lateral patellofcmoral angle (LPFA),modified Kujala score,The Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC),and SF-12quality of life scale.Results All the patients were followed up for an average of 7.6±3.4 months (from 4to 13 months).The PFCA was improved from preoperative 22.9°±7.6°to 12.4°±4.2°at the last follow-up,the LPFA from preoperative 3.2°±3.7°to 12.9°±6.0°at the last follow-up,the modified Kujala score from preoperative 17.1±9.8to 34.3±5.7at the last follow-up,the WOMAC from preoperative 14.1±5.2 to 5.9±1.7at the last follow-up,the stiffness index from preoperative 5.5±3.2 to 2.7±1.2 at the last follow-up,daily functional index from preoperative 43.9±9.0 to 25.2±5.4 at the last follow-up,and the SF-12 scores from preoperative 31.3±5.2 to 55.7±6.0 at the last follow-up.All the above comparisons showed a significant difference (P <0.05).Conclusion PLPF combined with LRR is a minimally invasive,easy-to-master and effective knee joint preserving procedure for PFOA as it can significantly relieve joint pain and maximally keep patellar functions.

关 键 词：骨关节炎 膝 关节成形术 外科手术 微创性 外侧支持带松解术 保膝手术 

分 类 号：R687.4[医药卫生—骨科学]