关节镜下腘绳肌腱重建内侧髌股韧带治疗青少年习惯性髌骨脱位的疗效观察  

Clinical effect of arthroscopic hamstring tendon medial patellofemoral ligament reconstruction in treatment of juvenile habitual patellar dislocation

作　　者：陈进[1] 王强[1] 董利军[1] 黄德刚[1] 贺华正[1] CHEN Jin WANG Qiang DONG Lijun et al(Department of Orthopaedics, The First Affiliated Hospital of Wannan Medical College, Wuhu 241000, China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院骨科,安徽芜湖241000

出　　处：《华北理工大学学报（医学版）》2016年第6期438-442,共5页Journal of North China University of Science and Technology：Health Sciences Edition

摘　　要：①目的探讨关节镜下胭绳肌腱重建内侧髌股韧带术治疗青少年习惯性髌骨脱位的，临床疗效。②方法2013年12月-2016年2月来我院就诊17例（18膝）青少年习惯性髌骨脱位患者，术前均行双下肢全长片及膝关节CT平扫等影像学资料测量髌骨Q角、胫骨结节-滑车间距（TT～TG值），17例（18膝）患者术前及术后膝关节功能疗效评比均使用Lysholm评分、IKDC功能评分、Kujala评分。③结果所有患者随访时间3～30个月，平均（14．47±7．67）个月，随访过程中无脱落。术后所有患者膝关节功能较术前明显改善，且髌骨没有发生再次脱位的现象，髌骨轴位片示膑股关节面良好，髌骨外推以及恐惧实验均转为阴性。术前与术后膝关节Lysholm评分[（53．778±9．334）、（86．889±7．918）]，IK—DC评分[（51．389±8．952）、（85．833±10．007）]，Kujala膝关节主观功能评分[（50．556±8．403）、（87．944±8．349）]，差异均有统计学意义（P均〈0．05）。④结论关节镜下胭绳肌腱重建内侧髌股韧带术治疗青少年髌骨习惯性脱位，患者术后膝关节功能得到明显提高，其疗效值得肯定。Objective To explore the clinical effect of arthroscopic hamstring tendon medial patellofemoral ligament reconstruction in treatment of juvenile habitual patellar dislocation. Methods Analyzed from December 2013 to February 2016 in our hospital 17 cases （18 patellas） with habitual patellar dislocation adolescent patients, Q-angles and TT-TG values in all patients were routinely measured before surgery, though Full-length radiographs of both lower limbs, knee CT scan and other imaging data, the preoperative and postoperative effect was evaluated by Lysholm scores, IKDC scores, Kujala scores. Results During follow-up with no loss,all patients were followed up for 3-30 （14.47± 7.67）months, All the patients knee function improved significantly compared with that before surgery,and without redislocation of the patella.Patellar axial radiograph pointed good patellar articular surface,the patella extrapolation and the patellar apprehension test showed negative in all patients at follow-up.The preoperative and postoperative Lysholm knee function scores were （53. 778 ± 9. 334）, （86.889±7.918） ,The preoperative and postoperative IKDI knee function scores were（51.389±8.952）, （85.833±10.007）, The preoperative and postoperative Kujala knee function subjective scores were （50.556±8.403）, （87.944±8.349）.These function scores increased significantly（ P 〈0.05）.There were statistically significant difference.Conclusion Arthroscopic hamstring tendon medial patellofemoral ligament reconstruction treat adolescents habitual dislocation of the patella, and postoperative knee function improve significantly, its effect is worthy of recognition.

关 键 词：关节镜 髌股韧带 髌骨脱位 支持带松解 

分 类 号：R686.5[医药卫生—骨科学]