韧带张力测量在髌骨外脱位内侧髌股韧带重建术中的应用评价  

Evaluation of Ligament Tension Measurement in Reconstruction of Medial Patellaremoral Ligament in External Patellar Dislocation

作　　者：艾尔西丁·阿不来提[1] 米尔阿地力·麦麦提依明 马强[1] 王小挺[1] 徐昌[1] 沈志敏[1] AIERXIDING·Abulaiti;MIERADILI·Maimaitiyiming;MA Qiang;WANG Xiao-ting;XU Chang;SHEN Zhi-min(The Second Joint Surgery Department,the Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830002,China)

机构地区：[1]新疆医科大学第六附属医院关节外二科,乌鲁木齐830002

出　　处：《骨科》2021年第6期518-522,共5页ORTHOPAEDICS

摘　　要：目的评价重建韧带张力的测量在髌骨外脱位内侧髌股韧带(medial patellaremoral ligament,MPFL)重建术中的应用效果。方法前瞻性纳入我科2014年1月至2018年12月收治的髌骨外脱位病人共75例,并随机分为两组。观察组36例,利用拉力秤张力测量的方法,选取自身的胫骨结节内侧半腱肌腱,镜下辅助双股MPFL重建术进行治疗;对照组39例,术中未使用拉力秤,以手法复位髌骨的方式重建MPFL。术后采用膝关节损伤和骨关节炎评分(knee injury and osteoarthritis outcome score,KOOS)、Kujala评分、髌骨适合角、髌骨倾斜角来评价临床效果。结果随访过程中3例病人失访(观察组1例,对照组2例),72例随访14~54个月(平均42个月)。两组病人治疗后的KOOS评分、Kujala评分、髌骨适合角、髌骨倾斜角均较术前得到改善,与术前数值比较,差异有统计学意义(P<0.05)。但两组手术前后的KOOS评分、Kujala评分、髌骨适合角、髌骨倾斜角的差值比较,差异无统计学意义(P>0.05)。对照组1例病人术后出现髌骨高压的症状。结论术中采用拉力秤辅助固定韧带是简单有效的预防术后髌股关节高压症的方法。Objective To evaluate the effect of measuring the tension of reconstructed ligament in the reconstruction of medial patellaremoral ligament(MPFL)with external patellar dislocation.Methods A total of 75 patients with patellar external dislocation treated in our department from January 2014 to December 2018 were prospectively included and randomly divided into two groups.A total of 36 patients treated with double strand MPFL reconstruction assisted by microscope were included in the observation group,and in the control group,39 patients were not given the tension scale during the operation,and the MPFL was reconstructed by manual reduction of patella.The knee injury and osteoarthritis outcome score(KOOS),Kujala score,congruence angle,patellar tilt angle were used to evaluate the clinical effect.Results Three patients were lost to follow-up(1 in observation group and 2 in control group),and 72 patients were followed up for 14-54 months(average 42 months).The KOOS,Kujala score,congruence angle,patellar tilt angle were improved after treatment,and the difference were statistically significant(P<0.05),but there was no significant difference between the two groups(P>0.05).In the control group,one patient developed patellar hypertension after operation.Conclusion It is a simple and effective method to prevent patellar hypertension by using tension beam to fix ligament during operation,but it still needs further research and application.

关 键 词：髌骨脱位 内侧髌股韧带 重建 关节镜检查 

分 类 号：R687.4[医药卫生—骨科学]