CAJ | 학술논문

目的：探讨关节镜辅助带线锚钉治疗急性髌骨脱位的临床效果。方法回顾性分析我院2010年3月—2013年6月期间获得10个月以上随访的26例急性髌骨脱位患者的临床资料。患者术前均进行查体及影像学检查。手术在关节镜监视下进行。首先引流关节内血肿，探查并修复关节内软骨损伤；观察髌骨与股骨外髁的对应关系，再行外侧支持带松解及带线锚钉修复内侧髌股韧带，观察治疗后髌骨复位情况及与股骨滑车的对应关系。结果所有患者在关节镜下显示均存在髌骨内侧面骨软骨损伤及股骨外髁骨挫伤，同时合并内侧髌股韧带损伤及髌外侧支持带紧张。随访10~18个月，未发现再次脱位，恐惧试验均转为阴性。术后Lysholm评分（分：91.38±1.65 vs 60.04±3.93）、Kujala评分（分：90.62±2.08 vs 55.27±3.00）、髌骨外倾角（11.96°±1.43° vs 25.15°±2.13°）均较术前有所改善（均P＜0.01）。结论关节镜辅助带线锚钉治疗急性髌骨脱位可防止髌骨再次脱位，缓解症状，恢复伸膝功能，效果良好。
목적：탐토관절경보조대선묘정치료급성빈골탈위적림상효과。방법회고성분석아원2010년3월—2013년6월기간획득10개월이상수방적26례급성빈골탈위환자적림상자료。환자술전균진행사체급영상학검사。수술재관절경감시하진행。수선인류관절내혈종，탐사병수복관절내연골손상；관찰빈골여고골외과적대응관계，재행외측지지대송해급대선묘정수복내측빈고인대，관찰치료후빈골복위정황급여고골활차적대응관계。결과소유환자재관절경하현시균존재빈골내측면골연골손상급고골외과골좌상，동시합병내측빈고인대손상급빈외측지지대긴장。수방10~18개월，미발현재차탈위，공구시험균전위음성。술후Lysholm평분（분：91.38±1.65 vs 60.04±3.93）、Kujala평분（분：90.62±2.08 vs 55.27±3.00）、빈골외경각（11.96°±1.43° vs 25.15°±2.13°）균교술전유소개선（균P＜0.01）。결론관절경보조대선묘정치료급성빈골탈위가방지빈골재차탈위，완해증상，회복신슬공능，효과량호。
Objective To investigate the clinical efficacy of arthroscopy with anchor treatment on acute patellar dislo?cation. Methods Retrospective analysis of patient with acute patellar dislocation cases who visited our hospital from March 2010 to June 2013 and were followed up for 10 months or more after being discharged. Patients all underwent physical exami?nation and imaging examination before operations. All operations were performed under arthroscopy. Joint hematoma were first drained, then articular cartilage injury were explored and repaired. Corresponding relationship between patella and femo?ral condyle were observed. After that, lateral retinaculum was released and medial patellofemoral ligament was repaired by suture anchors. Finally patellar reduction and its corresponding relationship with femur were observed after operation. Re?sults Medial patella cartilage injury and bone contusion of femoral condyle were all observed under arthroscopy. Medial patellofemoral ligament damage and tensed lateral patellar retinaculum were combined. By the time of follow-up at 10~18 months later, no dislocation was found and fear test are all positive. No recurrence of patellar dislocation was observed. Compared the conditions before operation and the last follow-up, Lysholm score(91.38±1.65 vs 60.04±3.93), Kujala score (90.62±2.08 vs 55.27±3.00),patellar camber angle(11.96°±1.43° vs 25.15°±2.13°)were all imporved(P<0.01). Conclu?sion Arthroscopy with suture anchors present good clinical effect in the treatment of acute patellar dislocation, which in?cludes alleviating keen pain, stabilizing joint instability and restoring knee stretching. It also present with less recurrence of patellar dislocation.