CAJ | 학술논문

目的：探讨关节镜辅助下小切口微创治疗急性髌骨脱位的方法和疗效。方法2008年7月至2011年9月，我科收治急性髌骨脱位14例，男9例，女5例；年龄16~28岁，平均（21.8±5.3）岁。患者入选条件：所有患者均有明确膝关节暴力外伤史，排除关节松弛和髌股关节发育异常。从发生髌骨脱位到手术的时间间隔为3~14 d，平均5.6 d。术中先行关节镜检查并清理关节腔内积血和处理关节软骨损伤后，在髌骨内侧做1个1.5 cm 长纵行小切口，通过上下推移皮肤，在髌骨中上部拧入带线锚钉，使用过线方法折叠缝合髌内侧支持带，视髌骨复位情况行外侧支持带松解。结果14例患者获得随访，术后随访24~60个月，平均36.1个月。全部病例未再次发生脱位，恐惧试验全部阴性。关节活动度均在正常范围，3例关节早期过屈时有轻度紧张感，随访患者均恢复伤前的生活状态。所有病例均未出现重度髌股关节退行性改变。结论关节镜辅助下小切口治疗急性髌骨脱位安全、可行，疗效显著。
목적：탐토관절경보조하소절구미창치료급성빈골탈위적방법화료효。방법2008년7월지2011년9월，아과수치급성빈골탈위14례，남9례，녀5례；년령16~28세，평균（21.8±5.3）세。환자입선조건：소유환자균유명학슬관절폭력외상사，배제관절송이화빈고관절발육이상。종발생빈골탈위도수술적시간간격위3~14 d，평균5.6 d。술중선행관절경검사병청리관절강내적혈화처리관절연골손상후，재빈골내측주1개1.5 cm 장종행소절구，통과상하추이피부，재빈골중상부녕입대선묘정，사용과선방법절첩봉합빈내측지지대，시빈골복위정황행외측지지대송해。결과14례환자획득수방，술후수방24~60개월，평균36.1개월。전부병례미재차발생탈위，공구시험전부음성。관절활동도균재정상범위，3례관절조기과굴시유경도긴장감，수방환자균회복상전적생활상태。소유병례균미출현중도빈고관절퇴행성개변。결론관절경보조하소절구치료급성빈골탈위안전、가행，료효현저。
Objective To explore the clinical methods and effects of arthroscopically minimally invasive treatment of a-cute patellar dislocation. Methods From July 2008 to September 2011,14 patients with acute patellar dislocation were trea-ted,including 9 males and 5 females with an average age of(21. 8 ± 5. 3)years. All had history of knee trauma,without knee laxity and dysplasia of patellofemoral joint. All the patients experienced arthroscopic examination first and removed of hemar-throsis and treat of injured artificial surface. Then through a 1. 5 cm incision at median rim of patella,pushing the skin,anchor fixation method was applied to fold medial retinaculum for reconstruction. Lateral patellofemoral ligament would be released de-pended on the conditions. Results 14 patients were followed up postoperatively from 24 ~ 60 months with an average of 72. 2 months. The patients had no recurrence of dislocation after operation,the apprehensive tests were negative and their ranges of motion returned to normal. 3 of them got a slight feeling of stress when the knee was overflexed but all resumed the pretrauma life state. The structures of patellofemoral joint were normal and the areas of injured cartilage got neither enlarged nor further degenerated on radiographs and MRI. Conclusion Arthroscopically minimally invasive treatment of acute patellar dislocation is an easily operation and has a number of benefits. Its clinical outcome is reliable.