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作 者:贾川 徐建达[2] 谢子康[2] 瞿玉兴[2] JIA Chuan;XU Jian-da;XIE Zi-kang;QU Yu-xing(Nanjing University of Traditional Medicine,Nanjing 213003, China;Department of Orthopaedics, Changzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing Uuniversity of Traditional Chinese Medicine, Changzhou 213003, Jiangsu Province, China)
机构地区:[1]南京中医药大学,南京210023 [2]南京中医药大学附属常州市中医医院骨一科,江苏常州213003
出 处:《中国临床解剖学杂志》2018年第6期683-689,共7页Chinese Journal of Clinical Anatomy
摘 要:目的探究在治疗臀肌挛缩合并膝前痛病症时恢复髌骨正常轨迹的必要性。方法臀肌挛缩症合并膝前疼痛的患者30例,随机分为对照组16例(单纯行关节镜臀肌挛缩松解术)及实验组14例(行关节镜臀肌挛缩松解术联合内侧髌骨支持带紧缩及外侧支持带松解)。观察患者不同术式术后恢复情况,并比较手术前后WOMAC评分、Kujala评分、髌骨和谐角、外侧髌骨角以及并发症等。结果术后2组30例均获得随访,平均随访时间14.3个月,切口均愈合良好。WOMAC评分、Kujala评分、髌骨和谐角、外侧髌骨角,对照组与实验组在术前评分均无明显差异(P>0.25)。两组术后1月、3月、6月患者WOMAC评分及髌骨和谐角较前明显降低(P<0.05),Kujala评分及外侧髌骨角较前明显升高(P<0.05)。两组对比,术后1月、3月、6月实验组WOMAC评分、Kujala评分、髌骨和谐角、外侧髌骨角均优于对照组(P<0.05)。结论关节镜下臀肌挛缩松解联合髌骨支持带重建较单纯关节镜下臀肌挛缩松解更能缓解长期臀肌挛缩导致的膝前痛等症状,且更好的减少髌骨外侧移位。Objective To investigate the necessity of restoring the normal trajectory of the humerus in the treatment of gluteal muscle spasm and anterior knee pain. Methods Thirty patients with orthopedic gluteal muscle contracture and anterior knee pain were randomly divided into a control group (n=16) (arthroscopic arthritis gluteal muscle contraction release) and an experimental group (n=14) (arthroscopic gluteal muscle contracture release combined with tightening of the medial patellofemoral reticulum and release of the lateral patellofemoral reticulum). Then the patients with different surgical methods were observed for postoperative recovery, and the WOMAC score, Kujala score, iliac bone harmony angle, lateral humeral angle and complications were compared before and after surgery. Results All the 30 patients in the 2 groups were followed up. The average follow- up period was 14.3 months. All incisions healed well. There were no significant difference between the control group and the experimental group in terms of the WOMAC score, Kujala score, iliac bone harmony angle, and lateral humeral angle (P>0.25). The WOMAC scores and tibia harmony angles of the patients in the two groups were significantly lower in the first month, third month, and sixth month after the operation (P<0.05). The Kujala score and lateral tibia angle were significantly higher than before (P<0.05). Compared with the control group, the WOMAC score, Kujala score, iliac bone harmony angle and lateral tibia angle of the experimental group were better than those of the control group in the first month, third month, and sixth month after the operation (P<0.05). Conclusions Arthroscopic gluteal muscle contraction released combined with patellofemoral reticulum can better relieve the symptoms of anterior knee pain caused by long-term gluteal muscle contracture and reduce the lateral displacement of the tibia.
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