关节镜辅助下三联术治疗复发性髌骨脱位  

Arthroscopically assisted triple surgery for treatment of recurrent patellar dislocation

作　　者：梅晓亮[1] 张震祥[1] 黄爱兵[1] 朱伟[1] 

机构地区：[1]泰州市人民医院骨科,江苏泰州225300

出　　处：《临床骨科杂志》2017年第1期102-105,共4页Journal of Clinical Orthopaedics

基　　金：国家自然科学基金(编号:81401770)

摘　　要：目的探讨关节镜辅助下三联术治疗复发性髌骨脱位的疗效。方法对18例复发性髌骨脱位患者在关节镜辅助下行外侧支持带松解、内侧髌股韧带重建及改良Fulkerson截骨三联术。术后进行髌骨外推恐惧试验,观察再脱位率,测量髌股适合角和外侧髌股角,采用Lysholm和Kujala评分评价膝关节功能。结果患者均获得随访,时间6~36个月。术后6个月内,有2例出现髌骨外侧疼痛,经康复理疗后均逐渐好转或消失。18例患者术后恐惧试验均阴性,随访期间无髌骨再脱位,Q角在正常范围。末次随访时患膝CT显示:髌股适合角5.83°±2.46°、外侧髌股角3.52°±0.64°、Lysholm膝关节功能评分93.28分±3.32分;Kujala髌股关节评分92.15分±12.43分,与术前比较差异均有统计学意义(P<0.05)。结论关节镜辅助下三联术治疗复发性髌骨脱位能恢复髌股关节功能并有效防止复发。Objective To investigate the clinical results of arthroscopically assisted for treatment of recurrent patellar dislocation. Methods The 18 patients of recurrent patellar dislocation patellar were treated by arthroscopic lateral retinaculum release,reconstruction of the medial patellfemoral ligament（ MPFL） combined with improved Fulkerson＇s osteotomy. Postoperative follow-up included patella extrapolation fear test,redislocation rate,measurement of patellofemoral suitable angle and lateral patellofemoral angle by Lysholm and Kujala scores in the evaluation of knee joint function. Results All the patients were followed up for 6 - 36 months. During the first 6 months after operation,2knees suffered pain of soft tissue later to the patella,however,the problem disappeared or recovered gradually after rehabilitation and conservative treatment. No recurrence of dislocation was observed during the follow-up,apprehensive test of all the 18 cases were negative and quadriceps angle was in the normal range. At the end of follow-up,CT examination showed that the congruence angle,lateral patellofemoral angle were 5. 83° ± 2. 46° and 3. 52° ± 0. 64°,the mean Lysholm score and the mean Kujala score were 93. 28 ± 3. 32 and 92. 15 ± 12. 43,respectively. It was showed statistically significant differences compared with preoperation（ P〈0.05）. Conclusions The treatment of recurrent patellar dislocation through procedure of arthroscopically assisted triple surgery is effective to prevent recruence and restore knee function as possible.

关 键 词：复发性髌骨脱位 关节镜检查 内侧髌股韧带重建 Fulkerson截骨术 

分 类 号：R687.4[医药卫生—骨科学] R684.7[医药卫生—外科学]