髌骨外侧支持带松解修复前后:膝关节参数变化的意义  

Lateral retinacular release: changes in knee joint parameters

作　　者：隋金颇[1] 葛帮荣[2] 谢士成[1] 段国庆[1] 张元民[1] 赵晓伟[1] 

机构地区：[1]济宁医学院附属医院,山东省济宁市272029 [2]济宁市第一人民医院,山东省济宁市272011

出　　处：《中国组织工程研究》2015年第11期1722-1726,共5页Chinese Journal of Tissue Engineering Research

基　　金：济宁市科技局课题资助项目(济科字[2011]57号)~~

摘　　要：背景:髌骨外侧支持带松解对于膝前痛在临床实践中是有意义的,但没有在膝关节参数测量下证实。目的:通过分析髌骨外侧支持带松解前后患者髌骨轴位X射线片上的相关参数,得出髌骨轴位片上对髌股关节紊乱最具临床意义的有效参数。方法:随机选取2009年2月至2013年12月济宁医学院附属医院关节科收治的50例膝前痛患者,OuterbridgeⅠ-Ⅲ级患者45例在关节镜下松解外侧支持带、修整关节软骨,另5例软骨损伤OuterbridgeⅣ级患者行外侧支持带松解的膝关节表面置换。结果与结论:与治疗前相比,外侧支持带松解后患者髌股指数、倾斜角及合适角均明显缩小(P<0.05或P<0.01),而外侧髌股角未出现明显变化(P>0.05),且髌骨运动轨迹恢复到原来相对应的股骨髁中央位置,同时未观察到关节血肿、深静脉血栓形成及髌骨半脱位等并发症。说明外侧支持带松解对于治疗髌股外侧高压引起的膝前痛是有意义的。BACKGROUND：Lateral retinacular release is effective to treat anterior knee pain, but it has not been confirmed through the parameters of the knee joint. OBJECTIVE： To analyze the relevant parameters on the axial X-ray films of the patela before and after lateral retinacular release and then to find out the efficient parameters for patelofemoral joint disorders on the axial X-ray film of the patela, which are of most clinical significance. METHODS： Fifty patients with anterior knee pain were included randomly who admitted at the Department of Joint Surgery, Affiliated Hospital of Jining Medical University from February 2009 to December 2013, including 45 cases of Outerbridge I-III undergoing arthroscopic lateral retinacular release＋articular cartilage repair and 5 cases of Outerbridge IV undergoing lateral retinacular release＋knee joint surface replacement. RESULTS AND CONCLUSION：After lateral retinacular release, the congruence angle, patelofemoral index and tilt angle were al reduced significantly （P 0.05）. The patelar trajectory restored to the corresponding central position of the femoral condyle, and meanwhile, no joint hematoma, deep vein thrombosis and patelar subluxation occurred. These findings indicate that the lateral retinacular release is of great significance for treatment of anterior knee pain induced by lateral patelofemoral compression.

关 键 词：髌股骨关节 疼痛 关节镜 膝关节 组织构建 组织工程 膝关节参数 骨关节损伤 髌股关节紊乱 支持带松解 膝前痛 合适角 髌股指数 倾斜角 外侧髌股角 膝关节置换 

分 类 号：R318[医药卫生—生物医学工程]