摘要
目的:探讨逐级外侧松解联合内侧髌股韧带(medial patellofemoral ligament,MPFL)重建治疗青少年习惯性髌骨脱位的临床疗效。方法:回顾性分析2022年1月至2024年12月我科收治的11例青少年习惯性髌骨脱位患者,其中男性6例、女性5例,平均年龄13.1(9~17)岁。由于存在不同程度的伸膝装置挛缩,所有患者均按逐级外侧松解联合MPFL重建的方案治疗。记录患者髌骨高度(Caton-Deschamps index),股骨滑车发育不良类型(Dejour分型),胫骨结节-股骨滑车沟距离(tibial tubercle-trochlear groove distance,TT-TG)以及髌骨倾斜角(patellar tilt angle,PTA)。比较患者术前和末次随访时Kujala评分、Lysholm评分以及膝关节损伤与骨关节炎评分(Knee Injury and Osteoarthritis Outcome Score,KOOS)。统计术后并发症、患者满意度及重返运动情况。结果:所有患者均获得随访,术后平均随访时间为20.1(8~36)月,无伤口感染、再脱位、关节活动受限、髌骨骨折以及生长受限等并发症发生。膝关节功能评分Kujala评分,Lysholm评分,KOOS疼痛、症状、日常功能、运动功能以及生活质量评分分别由术前68.5±7.0分、69.3±6.1分、67.4±5.1分、59.7±6.4分、53.3±3.1分、50.0±10.7分、38.6±12.4分,提高到末次随访时89.7±7.4分、91.2±7.1分、84.1±9.5分、82.5±8.2分、83.2±5.1分、75.0±11.6分、70.5±13.4分(P<0.05)。末次随访时所有患者均重返运动,患者平均满意度为8.7(7~10)。结论:逐级外侧松解联合内侧髌股韧带重建治疗青少年习惯性髌骨脱位可获得良好的短期临床疗效,显著改善膝关节功能,提高患者满意度。
Objective To investigate the short-term clinical outcomes of stepwise release of the exten-sor mechanism combined with medial patellofemoral ligament(MPFL)reconstruction in the treatment of habitual patellar dislocation(HPD)among adolescents.Methods A retrospective analysis was conduct-ed on the clinical data of 11 adolescents admitted to our department for patellar dislocation between January 2022 and December 2024.The cohort included 6 males and 5 females,with a mean age of 13.1 years(range,9~17 years).All patients underwent stepwise lengthening of the contracture of the extensor mechanism and MPFL reconstruction.Their trochlear dysplasia was classified according to the Dejour classification.Moreover,the tibial tubercle-trochlear groove(TT-TG)distance,patellar tilt angle(PTA)and Caton-Deschamps index(CDI)were measured.Moreover,before the operation and at the last follow-up,all patients were compared the Kujala,Lysholm,and Knee Injury and Osteoar-thritis Outcome Score(KOOS)scores.Meanwhile,during the final follow-up,the patient satisfaction,return to sports,and complications were recorded.Results All patients were followed up,with a mean follow-up duration of 20.1(8~36)months.No infection,re-dislocation,stiffness,patellar fracture or growth disturbance was observed in any of the cases.Moreover,all clinical and functional scores im-proved significantly(P<0.05),with the mean Kujala,Lysholm,KOOS-pain,KOOS-symptoms,KOOS-daily function,KOOS-motor function and KOOS-quality of life scores rising from 68.5±7.0,69.3±6.1,67.4±5.1,59.7±6.4,53.3±3.1,50.0±10.7 and 38.6±12.4 to 89.7±7.4,91.2±7.1,84.1±9.5,82.5±8.2,83.2±5.1,75.0±11.6 and 70.5±13.4,respectively(P<0.05).What's more,all patients returned to sports,with the average satisfaction score of 8.7(out of 10).Conclu-sion The treatment in this study yields favorable short-term clinical outcomes,significantly bettering knee function and subjective satisfactionof HPD patients.
作者
华义
王华
杨旭
Hua Yi;Wang Hua;Yang Xu(Department of Joint Surgery and Sports Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)
出处
《中国运动医学杂志》
北大核心
2026年第1期3-9,共7页
Chinese Journal of Sports Medicine
关键词
青少年
习惯性髌骨脱位
逐级外侧松解
内侧髌股韧带
adolescent
habitual patellar dislocation
stepwise lengthening
medial patellofemoral ligament
