关节镜下髌外侧支持带松解配合术后电刺激治疗髌外侧高压综合征的疗效观察  

Effect of arthroscopic lateral patellar retinaculum release and postoperative electrical stimulation on excessive lateral pressure syndrome

作　　者：王恒俊[1] 吴世栋[1] 董占引[1] WANG Hengjun;WU Shidong;DONG Zhanyi(Department of Joint Surgery, Cangzhou Hospital of Integrated TCM-WM, Cangzhou 061001, Hebei, China)

机构地区：[1]沧州中西医结合医院关节外科,河北沧州061001

出　　处：《中华骨与关节外科杂志》2018年第12期918-921,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:髌外侧高压综合征是一种常见的髌关节疾病,影响患者生活质量。目的:探讨关节镜下髌外侧支持带松解配合术后电刺激治疗髌外侧高压综合征的效果。方法:选取2015年1月至2016年10月于我院治疗的髌外侧高压综合征患者100例,根据治疗方案分为观察组和对照组,各50例,观察组予关节镜下髌外侧支持带松解配合术后股内侧斜肌电刺激治疗,对照组予关节镜下髌外侧支持带松解术,观察两组治疗效果、VAS评分、Lysholm评分,肌肉萎缩的改善,膝关节CT评估髌骨适合角(congruence angle, CA)、髌骨倾斜角(patellar tilt angle, PTA)和髌骨外移度(patellar lateral shift,PLS);同时采用ISOMED2000等速肌力仪和MEGA6000-T16表面肌电测试仪检测治疗前后屈伸肌力比值和肌电振幅比值。结果:观察组治疗效果明显好于对照组,观察组和对照组总有效率分别为96.0%和86.0%;治疗后6个月观察组VAS评分明显低于对照组[(2.6±1.0) vs (4.3±1.1)分,P<0.05];Lysholm评分明显高于对照组[(91.0±6.2) vs (82.1±6.0)分,P<0.05];两组CA、PTA和PLS均较治疗前改善(P<0.05);两组CA、PTA、PLS比较差异无统计学意义(P>0.05);观察组髌上10 cm周径明显高于对照组[(45.10±3.24)vs(42.16±3.10)cm,P<0.05];观察组屈伸肌肌力比值、股内侧肌/股直肌肌电振幅比值、股内侧肌/股外侧肌肌电振幅比值明显高于对照组(P<0.05)。结论:关节镜下髌外侧支持带松解配合术后电刺激治疗髌外侧高压综合征的效果较好,有助于提高髌骨的动力稳定结构,改善髌骨轨迹。Background:Excessive lateral pressure syndrome is a common patellar joint disease, which seriously threatens the quality of life of patients.Objective:To investigate the effect of arthroscopic lateral patellar retinaculum release and postopera-tive electrical stimulation in treatment of excessive lateral pressure syndrome.Methods:A total of 100 patients with excessive lateral pressure syndrome treated in our hospital from January 2015 to October 2016 were selected and divided into observa-tion group (n=50) and control group (n=50) according to the treatment plan. Patients in the observation group received ar-throscopic lateral patellar retinaculum release and the electrical stimulation after operation,and patients in the control group re-ceived arthroscopic lateral patellar retinaculum release. The curative effect, VAS score, Lysholm score and improvement in muscular atrophy were collected;the knee CT was used to assess the congruence angle (CA), the patellar tilt angle (PTA) and the patellar lateral shift (PLS);ISOMED 2000 isokinetic muscle tester and MEGA 6000-T16 surface electromyography tester were used to detect the ratio of flexion and extension muscle strength and the amplitude ratio of myoelectricity before and after treatment.Results:The curative effect of the observation group was better than that of the control group (P<0.05) and the total effective rate of the observation group and the control group were 96.0% and 86.0% respectively. The VAS score 6 months af-ter the treatment in observation group was significantly lower than that in the control group (2.6±1.0 vs 4.3±1.1, P<0.05);the Lysholm score was significantly higher in the observation group than in the control group (91.3±6.2 vs 82.1±6.0, P<0.05);CA, PTA and PLS were all improved after treatment in both groups (P<0.05) and there was no significant difference between the two groups (P >0.05);the circumference diameter superior patellar 10 cm was significantly higher in the observation group than in the control group [(45.10±3.24) vs (42.16±

关 键 词：关节镜 髌外侧支持带松解 髌外侧高压综合征 电刺激 

分 类 号：R687.4[医药卫生—骨科学]