摘要
目的：探讨关节镜辅助下应用自体腘绳肌腱小切口重建内侧髌股韧带治疗创伤性复发髌骨脱位的临床疗效。方法：收集2012年1月-2015年1月本院收治的采用关节镜辅助下小切口应用自体半腱肌重建内侧髌股韧带的方式治疗的50例髌骨脱位患者的资料,其中急性脱位18例,复发性脱位32例;男29例,女21例;平均年龄为24.1岁,髌骨脱位2-10次,末次髌骨脱位至手术时间为1-142个月,平均43.9个月。手术方法：关节镜探查清除嵌顿于髌股关节中的滑膜观察髌股关节运动轨迹、髌股关节软骨损伤程度,在关节镜直视下调整移植肌腱的张力使髌股关节运动轨迹恢复正常。重建术后按计划进行康复功能锻炼。结果：术后所有重建患者均随访,随访时间12-20个月,平均15.5个月。重建患者切口术后均无感染、内固定物排斥反应和重建韧带再次断裂。患者术后膝关节功能均得到了有效的恢复,术后髌骨关节对合好未再出现髌骨脱位及半脱位。膝关节伸直位和屈曲30°位髌骨外推试验和恐惧试验均为阴性。术后1年患者膝关节屈伸活动度均恢复正常,能够完全下蹲。重建术后进行12-20个月的随访,Lysholm、Kujala功能评分均显著性优于术前（P〈0.05）。结论：应用自体半腱肌在膝关节镜辅助下小切口重建内侧髌股韧带是治疗髌骨脱位的有效方法,术后膝关节功能恢复。
Objective：To explore the effectiveness of arthroscopic of the medial patellofemoral ligament reconstruction using Hamstring Autograft for traumatic recurrent patellar dislocation.Method：Clinical data of 50 cases with traumatic recurrent patellar dislocation were retrospectively analyzed from Jan 2012 to Jan 2015 in our department,including 29 males and 21 females with an average age of 24.1 years old.The patients suffered from 2-10 times patellar dislocation preoperatively.The average time between last dislocation and surgery was 43.9 months（1-142 months）.The surgical approach：arthroscopic examination was undertaken before the reconstruction to observe the patellofemoral congruence and the patellar track,as well as articular cartilage.The arthroscopic examination was taken again to measure the patellofemoral congruence and the patellar track after reconstruction.All cases accepted regular rehabilitation.Result：All patients were followed up 15.5 months on average（12-20 months）.No infection or graft rejection and rupture were observed in all cases.The patellar stability no recurrent dislocation or subdislocation occurred.All patients showed negative apprehension test at 0° and 30° flexions of knee.The range of motion of knee restored normal 1 year after operation.Follow-up 12-20 months,Lysholm and Kujala scores were used in preoperatively and postperatively,the diferences were significant（P0.05）.Conclusion：It is an effectiveness method that medial patellofemora ligament reconstruction of arthroscopic using Hamstring Autograft for traumatic recurrent patellar dislocation.
出处
《中国医学创新》
CAS
2016年第24期14-18,共5页
Medical Innovation of China
关键词
关节镜
内侧髌骨韧带
重建
髌骨脱位
Arthroscopy
Medial patellofemoral ligament
Reconstruction
Patellar dislocation
