关节镜下髌骨外侧支持带松解术治疗青少年髌骨半脱位的临床体会  

Arthroscopic release of lateral patellar retinaculum in the treatment of juvenile patellar subluxation

作　　者：马亮 蔡余力[1] 阎伟[1] 谢文鹏 骆帝 张文强[3] 刘帅 李刚[1] MA Liang;CAI Yu-li;YAN Wei(Department of Orthopaedics,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250012,China;Shandong Academy of Pharmaceutical Science)

机构地区：[1]山东中医药大学附属医院骨科,山东济南250012 [2]山东省药学科学院 [3]山东省千佛山医院骨科

出　　处：《腹腔镜外科杂志》2021年第9期707-710,共4页Journal of Laparoscopic Surgery

基　　金：中国博士后科学基金第68批面上资助(2020M682220);中国博士后科学基金第14批特别资助(2021T140423);齐鲁医派中医学术流派传承项目;齐鲁卫生与健康杰出青年人才培养工程。

摘　　要：目的:探讨关节镜下髌骨外侧支持带松解术治疗青少年髌骨半脱位的临床疗效。方法:回顾分析2018年3月至2020年3月为33例青少年髌骨半脱位患者行关节镜下髌骨外侧支持带松解术的临床资料。分别评估手术前后膝关节Lysholm评分、疼痛视觉模拟评分、Q角及膝关节活动范围。结果:33例手术均顺利完成,手术时间15~35 min,平均(25.3±6.4)min;术中出血30~85 mL,平均(54.4±14.3)mL。无手术导致的死亡病例,未发生血管损伤、神经损伤及感染等严重并发症;2例患者出现复发半脱位,予以石膏外固定。术后患者均获随访,随访12~18个月,平均(15.5±1.9)个月。术后患者Q角、膝关节活动度均得到有效矫正,差异有统计学意义;Lysholm与疼痛评分较术前明显改善,差异有统计学意义。结论:关节镜下松解髌骨外侧支持带可有效治疗青少年髌骨半脱位,调整Q角与髌股轨迹,改善膝关节疼痛及功能障碍。Objective:To investigate the clinical effect of arthroscopic release of lateral patellar retinaculum in the treatment of juvenile patellar subluxation.Methods:The clinical data of 33 adolescent patients with patellar subluxation treated with arthroscopic release of lateral patellar retinaculum from Mar.2018 to Mar.2020 were retrospectively analyzed.Lysholm score,pain visual analogue score,Q angle and motion range of knee joint were used to evaluate knee pain and function before and after operation.Results:All 33 operations were successfully completed,the operation time ranged from 15 to 35 min with the mean of(25.3±6.4)min,intraoperative bleeding was 30-85 mL,with an average of(54.4±14.3)mL.No death and no serious complications such as blood vessel damage,nerve damage and infection occurred due to surgery.Only 2 patients had recurrent subluxation and were externally fixed with plaster.All patients were followed up for 12 to 18 months,with an average of(15.5±1.9)months.The patients'Q angle and knee joint range of motion were effectively corrected after the operation,the difference was statistically significant.Lysholm and pain score significantly improved after surgery.Conclusions:Arthroscopic release of lateral patellar retinaculum can effectively treat patellar subluxation in adolescent patients,adjust Q angle and patellofemoral trajectory,and improve knee pain and dysfunction.

关 键 词：髌骨脱位 关节镜检查 髌骨外侧支持带松解术 青少年 

分 类 号：R684[医药卫生—骨科学]