膝关节镜辅助下内侧髌股韧带重建术治疗青少年急性创伤性髌骨脱位临床观察  

Clinical observation of knee arthroscopy-assisted medial patellofemoral ligament reconstruction for the treatment of adolescents with acute traumatic patellar dislocation

作　　者：张力 刘志磊 杨明明 胡开仲 王薪华[1] 赵炜[1] 孙根发[1] ZHANG Li;LIU Zhi-lei;YANG Ming-ming;HU Kai-zhong;WANG Xin-hua;ZHAO Wei;SUN Gen-fa(Department of Orthopedics,the Central Hospital of Ankang City,Ankang 725000,Shaanxi,CHINA)

机构地区：[1]安康市中心医院骨二科,陕西安康725000

出　　处：《海南医学》2021年第2期192-194,共3页Hainan Medical Journal

摘　　要：目的观察膝关节镜辅助下内侧髌股韧带(MPFL)重建术治疗青少年急性创伤性髌骨脱位的临床疗效。方法回顾性分析2017年6月至2019年6月因外伤致急性髌骨脱位累及髌骨内侧缘撕脱性骨折在安康市中心医院治疗的30例初次脱位患者的临床资料,所有患者采用自体半腱肌双束解剖重建内侧髌股韧带,比较患者术前、术后髌骨移动度及髌骨外侧角、髌骨适合角、髌骨倾斜角,采用Lysholm评分评估患者的膝关节功能。结果30例患者均获得随访,平均随访时间为(10.9±2.35)个月;体格检查髌骨倾斜试验、髌骨恐惧试验、髌骨外推试验均阴性,无再脱位发生;术后3 d CT测量髌骨外侧角较术前增加[(8.49°±2.36°)vs(5.25°±1.48°)]、髌股适合角较术前减小[(10.70°±2.12°)vs(20.79°±5.67°)]、髌骨倾斜角较术前减小[(11.83°±1.94°)vs(21.46°±4.79°)],差异均具有统计学意义(P<0.05);术后6个月,膝关节Lysholm评分为(90.67±3.82)分,较术前的(60.41±6.58)分明显提升,差异具有统计学意义(P<0.05)。结论膝关节镜辅助下内侧髌股韧带重建术治疗青少年急性创伤性髌骨脱位,能纠正髌骨运动轨迹不良,改善髌股关节功能,提高患者膝关节运动功能及生活质量,避免髌骨再次脱位发生,短期内效果良好。Objective To observe the clinical effect of knee arthroscopy-assisted medial patellofemoral ligament(MPFL)reconstruction in the treatment of adolescents with acute traumatic patellar dislocation.Methods From June 2017 to June 2019,the clinical data of 30 patients with acute dislocation of the patella and avulsion fracture of the medial margin of the patella admitted to the Central Hospital of Ankang City were analyzed retrospectively.The medial patellofemoral ligament was reconstructed by autogenous semitendinosus muscle double bundle anatomy.The patellar mobility before and after operation was compared.The lateral angle,fit angle,and inclination angle of the patella were measured by CT before and after operation,and Lysholm score was used to evaluate the knee function subjectively.Results All the patients were followed up,and the average follow-up time was(10.9±2.35)months.Physical examination showed that patellar tilt test,patellar fear test,and patellar extrapolation test were all negative,no redislocation occurred.After operation,the lateral angle of patella increased:preoperative(5.25°±1.48°)vs postoperative(8.49°±2.36°);the patellofemoral angle decreased:preoperative(20.79°±5.67°)vs postoperative(10.70°±2.12°);and the inclination angle of patella decreased:preoperative(21.46°±4.79°)vs postoperative(11.83°±1.94°);the differences were statistically significant(all P<0.05).The Lysholm score of knee joint at 6 months after operation was(90.67±3.82)points,which was significantly higher than(60.41±6.58)points before operation(P<0.05).Conclusion The reconstruction of medial patellofemoral ligament assisted by knee arthroscopy in the treatment of acute traumatic patellar dislocation in adolescents can correct the poor patellar track,improve the function of patellofemoral joint,increase the motor function and quality of life of the knee joint and avoid patella dislocation,with good short-term effect.

关 键 词：青少年 创伤性髌骨脱位 内侧髌股韧带 膝关节镜 双束重建 自体半腱肌 带线锚钉 

分 类 号：R684.7[医药卫生—骨科学]