关节镜下内侧髌股韧带重建结合外侧支持带松解及胫骨结节内移垫高治疗习惯性髌骨脱位  

Treatment of habitual dislocation of patella with reconstruction of medial patellofemoral ligament combined with release of lateral retinaculum and medial transfer and advancement of tibial tuberosity under arthroscopy

作　　者：吴李闯[1] 周海波[1] 张超[1] 陈雷[1] 刘彩龙[1] 

机构地区：[1]温州医科大学附属第一医院骨科,浙江温州325000

出　　处：《中国骨伤》2017年第11期986-990,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的 :探讨关节镜辅助下内侧髌股韧带重建、外侧支持带松解、Fulkerson胫骨结节截骨内移垫高术(三联术)治疗习惯性髌骨脱位的临床疗效。方法:对2010年3月至2016年5月收治的35例习惯性髌骨脱位患者的临床资料进行回顾性分析,男14例,女21例;年龄18~38岁,平均25.8岁;左膝12例,右膝23例。均采用关节镜辅助下内侧髌股韧带重建、外侧支持带松解、Fulkerson胫骨结节截骨内移垫高术治疗。对比术前术后Q角、TT-TG值及Kujala评分变化。结果:所有患者获随访,时间9~35个月,平均23个月。术后Q角男性组由(29.2±2.0)°改善为(14.8±1.2)°(P<0.05),女性组由(30.6±2.3)°改善为(16.7±1.5)°(P<0.05)。CT示TT-TG值由术前(20.3±2.2)mm改善为(10.3±1.2)mm(P<0.05)。术后Kujala评分由47.8±7.5改善至88.4±6.2(P<0.05)。结论 :关节镜辅助下内侧髌股韧带重建、外侧支持带松解、Fulkerson胫骨结节截骨内移垫高术治疗习惯性髌骨脱位近期临床疗效良好。Objective：To study clinical effects of triad operation including reconstruction of medial patellofemoral ligament,release of lateral retinaculum,Fulkerson tibial tubercle osteotomy,medial transfer and advancement under arthroscopy for the treatment of habitual dislocation of patella. Methods：From March 2010 to May 2016,35 patients with habitual patellar dislocation were treated with the triad operation,including 14 males,21 females,ranging in age from 18 to 38 years old,with an average of 25.8 years old. Twelve patients had dislocations on the left knee,and 23 patients had dislocations on the right knee.The changes of Q angle,TT-TG value and Kujala score were compared before and after operation. Results：All the patients were followed up,and the duration ranged from 9 to 35 months（mean,23 months）. The Q angle of male group was improved from preoperative（29.2±2.0） ° to postoperative（14.8±1.2）°（P〈0.05）,and the Q angle of female group was improved from preoperative（30.6±2.3）° to postoperative（16.7±1.5）°（P〈0.05）. CT showed that the TT-TG value was improved from preoperative（20.3±2.2） mm to postoperative（10.3±1.2） mm（P〈0.05）. The Kujala score was improved from preoperative 47.8±7.5 to postoperative 88.4±6.2（P〈0.05）. Conclusion：The triad operation including reconstruction of medial patellofemoral ligament,release of lateral retinacular,Fulkerson tibial tubercle osteotomy,medial transfer and advancement under arthroscopy for the treatment of habitual dislocation of patella has good short term clinical effects.

关 键 词：髌骨脱位 修复外科手术 膝关节 关节镜 

分 类 号：R684.7[医药卫生—骨科学]