青少年髌骨脱位内侧髌股韧带修复与重建比较  

Repair versus reconstruction of medial patellofemoral ligament for primary patellar dislocation in adolescents

作　　者：刘晨宏 张树全 张丰经 张慧园 王海波 杜海 王绍辉 LIU Chenhong;ZHANG Shu-quan;ZHANG Feng-jing;ZHANG Hui-yuan;WANG Hai-bo;HU Hai;WANG Shao-hui(Department of Pediatric Orthopedics,The Second Hospital of Zhangjiakou City,Zhangjiakou,Hebei 075000,China)

机构地区：[1]张家口市第二医院小儿骨科,河北张家口075000

出　　处：《中国矫形外科杂志》2025年第7期645-648,共4页Orthopedic Journal of China

基　　金：河北省省级科技计划资助项目(编号:20377719D);2022年度河北省医学课题研究项目(编号:20221881)。

摘　　要：[目的]对比修复与重建内侧髌股韧带(medial patellofemoral ligament,MPFL)治疗青少年初次创伤性髌骨脱位的疗效。[方法]2019年6月—2022年6月治疗初次创伤性髌骨脱位共26例(26膝),根据医患沟通结果,12例采用锚钉修复MPFL,另外14例采用大收肌腱双束重建MPFL。比较两组临床及影像资料。[结果]患者均顺利完成手术,无神经、血管损伤。修复组手术时间显著短于重建组[(54.9±7.8)min vs(84.2±8.9)min,P<0.001]。随访时间平均(31.0±11.6)个月。与术前相比,末次随访两组VAS评分显著减少(P<0.05),Kujala评分、膝ROM显著增加(P<0.05)。相应时间点,两组间VAS评分、Kujala评分、膝ROM差异均无统计学意义(P>0.05)。影像方面,与术前相比,末次随访两组髌骨倾斜角、髌外移、胫骨结节股骨滑车沟距离均显著减小(P<0.05),相应时间点,两组间上述影像指标的差异均无统计学意义(P>0.05)。[结论]MPFL修复或重建治疗青少年初次创伤性髌骨脱位短期疗效相近。[Objective]To compare clinical outcomes of repair verus reconstruction of medial patellofemoral ligament(MPFL)for primary traumatic patellar dislocation in adolescents.[Methods]From June 2019 to June 2022,a total of 26 patients(26 knees)were surgically treated for primary traumatic patellar dislocation.According to doctor-patient communication,12 adolescents were treated by MPFL repair with suture anchors,while other 14 patients were treated by double-bundle reconstruction of MPFL with adductor magnus tendon.The clinical and imaging data of the two groups were compared.[Results]All patients were successfully operated without nerve or vascular injuries.The repair group consumed significantly shorter operation time than the reconstruction group[(54.9±7.8)min vs(84.2±8.9)min,P<0.001].The patients were followed up for an average of(31.0±11.6)months.Compared with those preoperatively,the VAS score was significantly decreased(P<0.05),whereas the Kujala score and knee ROM significantly increased at the last follow-up(P<0.05),however,which proved not significantly different at any points accordingly between the two groups(P>0.05).In terms of imaging,compared with those preoperatively,the patellar inclination angle,patellar displacement and tibial tuberosity-trochlear groove(TT-TG)significantly decreased in the two groups at the last follow-up(P<0.05),and there were no statistically significant differences in the above imaging indicators between the two groups at any corresponding time points(P>0.05).[Conclusion]MPFL repair or reconstruction in the treatment of adolescents primary traumatic patellar dislocation has similar short-term clinical efficacy.

关 键 词：青少年 创伤性髌骨脱位 内侧髌股韧带 修复术 重建术 

分 类 号：R685.7[医药卫生—骨科学]