髌骨带线锚钉与半隧道聚醚醚酮锚钉固定双束重建内侧髌股韧带  

Patellar suture anchors and semi-tunneling polyetheretherketone suture anchors for double-bundle reconstruction of medial patellofemoral ligament

作　　者：韩明展 买合木提·亚库甫 陈洪涛[1] 刘建疆 阿布都苏甫·库万 艾尔肯·阿木冬[1] Han Mingzhan;Maihemuti·Yakufu;Chen Hongtao;Liu Jianjiang;Abudusufu·Kuwan;Aierken·Amudong(Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆医科大学第六附属医院,新疆维吾尔自治区乌鲁木齐市830011

出　　处：《中国组织工程研究》2022年第12期1854-1860,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:复发性髌骨脱位的治疗方式主要有内侧髌股韧带重建、内侧髌股韧带成形、外侧髌股韧带松解、臀肌挛缩松解与胫骨结节移位手术,目前多采用双束解剖重建内侧髌股韧带的方法。目的:在双束重建内侧髌股韧带的前提下,比较髌骨内缘使用带线锚钉与半隧道聚醚醚酮锚钉固定肌腱治疗复发性髌骨脱位的疗效。方法:选择2017年1月至2018年4月新疆医科大学第六附属医院收治的单侧复发性髌骨脱位患者57例,男19例,女38例,年龄16-26岁,均接受内侧髌股韧带重建治疗,移植物为患者自体半腱肌,其中26例采用带线锚钉进行移植物内固定,31例采用半隧道聚醚醚酮锚钉进行移植物内固定。术后进行随访,记录髌骨再脱位、骨折与其他并发症发生情况,以及髌骨倾斜角与患侧膝关节功能Kujala评分。结果与结论:(1)术后36个月随访中,57例患者均未发生切口不愈合、髌骨再次脱位、髌骨骨折;带线锚钉组出现4例股骨止点疼痛、1例韧带与股骨止点处持续疼痛,聚醚醚酮锚钉组出现5例股骨止点的疼痛,两组间疼痛发生率比较差异无显著性意义(P>0.05);(2)两组患者治疗后18,36个月的膝关节功能Kujala评分比较差异均无显著性意义(P>0.05);(3)带线锚钉组患者治疗后36个月的髌骨倾斜角大于半隧道聚醚醚酮锚钉组(P<0.05);(4)结果表明,髌骨带线锚钉和半隧道聚醚醚酮锚钉双束重建内侧髌股韧带均可有效治疗复发性髌骨脱位、改善患膝功能,但半隧道聚醚醚酮锚钉对髌骨倾斜角的改善更明显。BACKGROUND:The main treatment methods for recurrent patellar dislocation are medial patellofemoral ligament reconstruction,medial patellofemoral ligament formation,lateral patellofemoral ligament loosening,gluteal muscle contracture loosening,and tibial tubercle displacement surgery.At present,double-bundle anatomical reconstruction of medial patellofemoral ligament is mostly used.OBJECTIVE:To compare the efficacy of tendon fixation with suture anchors and tendon fixation with semi-tunneling polyetheretherketone suture anchors in the treatment of recurrent patellar dislocation under the condition of double-bundle reconstruction of medial patellofemoral ligament.METHODS:Totally 57 cases who were diagnosed as recurrent patellar dislocation in Sixth Affiliated Hospital of Xinjiang Medical University from January 2017 to April 2018 received parallel medial patellofemoral ligament revascularization,aged between 16 and 26 patients,including 19 males and 38 females.The graft was autologous semitendinosus muscle.Among them,26 cases received graft fixation with suture anchors,and 31 cases received graft fixation with semitunneling polyetheretherketone suture anchors.After surgery,follow-up was conducted to record patellar redislocation,fracture and other complications,patellar tilt angle,and Kujala score of the affected knee.RESULTS AND CONCLUSION:(1)During 36-month follow-up,57 patients did not affect unhealed incision,patellar redislocation,or patellar fracture.In the suture anchor group,four patients experienced pain at femoral insertion point and one patient suffered from persistent pain at ligament and femoral insertion point.In the polyetheretherketone suture anchor group,five patients affected pain at femoral insertion point.No significant difference in the incidence of pain was found between the two groups(P>0.05).(2)There was no significant difference in Kujala function score of knee joint at 18 and 36 months after operation between the two groups(P>0.05).(3)Patellar tilt angle was larger in the suture anchor gro

关 键 词：髌骨脱位 内侧髌股韧带 带线锚钉 聚醚醚酮锚钉 髌股关节 髌骨倾斜角 双束重建 解剖重建 

分 类 号：R459.9[医药卫生—治疗学] R684.7[医药卫生—临床医学]