内侧髌股韧带重建术后股骨隧道位置对膝关节功能的影响研究  

EFFECTS OF FEMORAL TUNNEL POSITION ON KNEE FUNCTION AFTER MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION

作　　者：阿依丁.夏哈太 张克远[1] 刘阳[1] 

机构地区：[1]新疆医科大学第一附属医院骨病.运动损伤科,乌鲁木齐830054

出　　处：《中国修复重建外科杂志》2015年第8期951-954,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：新疆医科大学第一附属医院院内青年科学基金项目(2014ZRQN14)~~

摘　　要：目的 探讨内侧髌股韧带（medial patellofemoral ligament,MPFL）重建术中股骨隧道位置对术后膝关节功能恢复的影响。方法 回顾分析2013年8月-2014年3月行MPFL重建术联合髌股外侧支持带松解术治疗的43例43膝复发性髌骨脱位患者临床资料。男12例,女31例;年龄9~35岁,平均19.4岁。患者均有外伤史,存在反复脱位现象。髌骨恐惧试验和J征阳性,髌骨倾斜试验示髌股外侧支持带紧张。术后采用Lysholm膝关节功能评分评定疗效,于CT三维重建图像上测量股骨隧道中心至股骨等距点的距离,评价股骨隧道位置是否等距;并对Lysholm评分与股骨隧道中心至股骨等距点的距离进行相关性分析。结果 术后切口均Ⅰ期愈合。患者均获随访,随访时间13~18个月,平均15个月。术后未出现髌骨半脱位或脱位,恐惧试验均呈阴性。末次随访时,Lysholm评分为83~100分,平均93.8分。术后测量股骨隧道中心至股骨等距点的距离为2~16 mm,平均5.61 mm。其中30例（69.8%）股骨隧道为等距隧道,13例（30.2%）为非等距隧道。股骨隧道中心至股骨等距点距离与术后Lysholm评分成负相关（r=—0.851,P=0.000）。等距隧道患者与非等距隧道患者Lysholm评分分别为（95.7±2.3）分与（89.4±3.5）分,比较差异有统计学意义（t=6.951,P=0.000）。结论 对于髌股关节不稳,MPFL重建术中制备股骨等距隧道能为膝关节功能的恢复奠定良好基础。Objective To study the effect of the femoral tunnel position on the knee function recovery after medial patellofemoral ligament（MPFL） reconstruction. Methods A retrospective analysis was made on the clinical date of 43 cases（43 knees） of recurrent patellar dislocation undergoing MPFL reconstruction and patellofemoral lateral retinaculum lysis between August 2013 and March 2014. There were 12 males and 31 females, aged 19.4 years on average（range, 9-35 years）. All patients had trauma history and recurrent dislocations. The results of apprehesion test and J syndrom were positive. The patellar tilt test showed patellofemoral lateral retinaculum was tension. The effectiveness was evaluated using Lysholm knee functional score after operation. The distance from the center of the femoral tunnel to the femoral isometric point was measured on CT three dimensional reconstruction image. Whether the femoral tunnel position was isometric was evaluated. The correlation was analyzed between the distance from the center of the femoral tunnel to the femoral isometric point and Lysholm score. Results Primary healing of incision was obtained in all patients. The patients were followed up 13-18 months（mean, 15 months）. No patellar dislocation or subluxation occurred. The result of apprehensive test was negative. At last follow-up, the average Lysholm score was 93.8（range, 83-100）. The average distance from the center of the femoral tunnel to the femoral isometric point was 5.61 mm（range, 2-16 mm）. The femoral tunnel position was isometric in 30 cases（69.8%） and non-isometric in 13 cases（30.2%）. The distance from the center of the femoral tunnel to the femoral isometric point was negatively correlated with postoperative Lysholm score（r= —0.851, P=0.000）. The postoperative Lysholm score was 95.7±2.3 in patients with isometric tunnel and was 89.4±3.5 in patients with non-isometric tunnel, showing significant difference（t=6.951, P=0.000）. Conclusion For patellofemoral joint instability, prepar

关 键 词：髌股关节不稳 内侧髌股韧带重建术 股骨隧道 等距点 

分 类 号：R687.4[医药卫生—骨科学]