中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2012年
2期
111-115
,共5页
刘阳%郑江%张明宇%张宪%周运平
劉暘%鄭江%張明宇%張憲%週運平
류양%정강%장명우%장헌%주운평
关节镜检查%髌骨脱位%修复外科手术
關節鏡檢查%髕骨脫位%脩複外科手術
관절경검사%빈골탈위%수복외과수술
Arthroscopy%Patellar dislocation%Reconstructive surgical procedures
目的 探讨关节镜下半腱肌肌腱移植双束解剖重建内侧髌股韧带治疗复发性髌骨脱位的疗效.方法 自2006年1月至2010年1月收治复发性髌骨脱位29例(31膝),男11例,女18例(20膝)；年龄16～32岁,平均22岁.游离自体半腱肌肌腱,双束重建内侧髌股韧带,以双锚钉及骨槽固定于髌骨,股骨止点采用界面螺钉固定,于关节镜下调整髌骨复位.5例同时行胫骨结节前内移术.所有病例均获得随访,随访时间9～22个月,平均14个月.影像学评价包括测量髌股适合角、外侧髌股角、髌骨外移率；临床疗效评价包括国际膝关节评分委员会(International Knee Documentation Committee,IKDC)膝关节功能主观评分、Lysholm膝关节功能评分及Tegner膝关节运动评分.结果 术后恐惧试验均阴性,随访期间无髌骨再脱位及骨折发生.末次随访时髌股适合角5.65°±2.23°、外侧髌股角3.52°±2.63°、髌骨外移率0.25±0.46,与术前比较差异有统计学意义(P＜0.05);IKDC膝关节功能主观评分(93.20±5.33)分、Lysholm膝关节功能评分(93.02±6.08)分及Tegner膝关节运动评分(6.58±0.87)分,与术前比较差异有统计学意义(P＜0.05).结论 关节镜下半腱肌肌腱移植双束解剖重建内侧髌股韧带治疗复发性髌骨脱位的近期效果可靠.
目的 探討關節鏡下半腱肌肌腱移植雙束解剖重建內側髕股韌帶治療複髮性髕骨脫位的療效.方法 自2006年1月至2010年1月收治複髮性髕骨脫位29例(31膝),男11例,女18例(20膝)；年齡16～32歲,平均22歲.遊離自體半腱肌肌腱,雙束重建內側髕股韌帶,以雙錨釘及骨槽固定于髕骨,股骨止點採用界麵螺釘固定,于關節鏡下調整髕骨複位.5例同時行脛骨結節前內移術.所有病例均穫得隨訪,隨訪時間9～22箇月,平均14箇月.影像學評價包括測量髕股適閤角、外側髕股角、髕骨外移率；臨床療效評價包括國際膝關節評分委員會(International Knee Documentation Committee,IKDC)膝關節功能主觀評分、Lysholm膝關節功能評分及Tegner膝關節運動評分.結果 術後恐懼試驗均陰性,隨訪期間無髕骨再脫位及骨摺髮生.末次隨訪時髕股適閤角5.65°±2.23°、外側髕股角3.52°±2.63°、髕骨外移率0.25±0.46,與術前比較差異有統計學意義(P＜0.05);IKDC膝關節功能主觀評分(93.20±5.33)分、Lysholm膝關節功能評分(93.02±6.08)分及Tegner膝關節運動評分(6.58±0.87)分,與術前比較差異有統計學意義(P＜0.05).結論 關節鏡下半腱肌肌腱移植雙束解剖重建內側髕股韌帶治療複髮性髕骨脫位的近期效果可靠.
목적 탐토관절경하반건기기건이식쌍속해부중건내측빈고인대치료복발성빈골탈위적료효.방법 자2006년1월지2010년1월수치복발성빈골탈위29례(31슬),남11례,녀18례(20슬)；년령16～32세,평균22세.유리자체반건기기건,쌍속중건내측빈고인대,이쌍묘정급골조고정우빈골,고골지점채용계면라정고정,우관절경하조정빈골복위.5례동시행경골결절전내이술.소유병례균획득수방,수방시간9～22개월,평균14개월.영상학평개포괄측량빈고괄합각、외측빈고각、빈골외이솔；림상료효평개포괄국제슬관절평분위원회(International Knee Documentation Committee,IKDC)슬관절공능주관평분、Lysholm슬관절공능평분급Tegner슬관절운동평분.결과 술후공구시험균음성,수방기간무빈골재탈위급골절발생.말차수방시빈고괄합각5.65°±2.23°、외측빈고각3.52°±2.63°、빈골외이솔0.25±0.46,여술전비교차이유통계학의의(P＜0.05);IKDC슬관절공능주관평분(93.20±5.33)분、Lysholm슬관절공능평분(93.02±6.08)분급Tegner슬관절운동평분(6.58±0.87)분,여술전비교차이유통계학의의(P＜0.05).결론 관절경하반건기기건이식쌍속해부중건내측빈고인대치료복발성빈골탈위적근기효과가고.
Objective To investigate the effect of recurrent patella dislocation by grafting dual-bundle semitendinosus to anatomically reconstruct of medial patellofemoral ligament(MPFL)under arthroscopy.Methods From January 2006 to January 2010,29 cases(31 knees)with recurrent dislocation of the patella were performed arthroscopic surgery,including 11 males and 18 females(20 knees)with an average age of 22 years(range,16-32).The key point of surgery was reconstruction MPFL with dual-bundle free autogenous semitendinosus by using two anchors and bone groove to fixed on the patella,and using the interference screw to fixed on the femur.Adjusting the patella reset under arthroscopy.Tibial tubercle were transferred to inside in 5 cases.All patients were followed up for an average of 14 months(ranging 9-22).The imaging evaluation included congruence angle,lateral patellofemoral angle and lateral shift.The clinical therapeutic effect was evaluated with International Knee Documentation Committee(IKDC),Lysholm and Tegner scores.Results The fear test was negative after operation.There was no redislocation and fracture of the patella during follow-up.The congruence angle,lateral patellofemoral angle and lateral shift were 5.65°±2.23°,3.52°±2.63° and 0.25±0.46 respectively at the final follow-up.The mean IKDC,Lysholm and Tegner scores were 93.20±5.33,93.02±6.08 and 6.58±0.87 respectively at the final follow-up.All were showed statistically significant differences compared with preoperation(P＜0.05).Conclusion It is demonstrated that there was a reliable short-term effect to treat recurrent patella dislocation by grafting dual-bundle semitendinosus to anatomically reconstruct of MPFL under arthroscopy.
