CAJ | 학술논문

背景：髌骨外侧支持带松解对于膝前痛在临床实践中是有意义的，但没有在膝关节参数测量下证实。目的：通过分析髌骨外侧支持带松解前后患者髌骨轴位X射线片上的相关参数，得出髌骨轴位片上对髌股关节紊乱最具临床意义的有效参数。方法：随机选取2009年2月至2013年12月济宁医学院附属医院关节科收治的50例膝前痛患者， OuterbridgeⅠ-Ⅲ级患者45例在关节镜下松解外侧支持带、修整关节软骨，另5例软骨损伤OuterbridgeⅣ级患者行外侧支持带松解的膝关节表面置换。结果与结论：与治疗前相比，外侧支持带松解后患者髌股指数、倾斜角及合适角均明显缩小(P <0.05或P<0.01)，而外侧髌股角未出现明显变化(P>0.05)，且髌骨运动轨迹恢复到原来相对应的股骨髁中央位置，同时未观察到关节血肿、深静脉血栓形成及髌骨半脱位等并发症。说明外侧支持带松解对于治疗髌股外侧高压引起的膝前痛是有意义的。
배경：빈골외측지지대송해대우슬전통재림상실천중시유의의적，단몰유재슬관절삼수측량하증실。목적：통과분석빈골외측지지대송해전후환자빈골축위X사선편상적상관삼수，득출빈골축위편상대빈고관절문란최구림상의의적유효삼수。방법：수궤선취2009년2월지2013년12월제저의학원부속의원관절과수치적50례슬전통환자， OuterbridgeⅠ-Ⅲ급환자45례재관절경하송해외측지지대、수정관절연골，령5례연골손상OuterbridgeⅣ급환자행외측지지대송해적슬관절표면치환。결과여결론：여치료전상비，외측지지대송해후환자빈고지수、경사각급합괄각균명현축소(P <0.05혹P<0.01)，이외측빈고각미출현명현변화(P>0.05)，차빈골운동궤적회복도원래상대응적고골과중앙위치，동시미관찰도관절혈종、심정맥혈전형성급빈골반탈위등병발증。설명외측지지대송해대우치료빈고외측고압인기적슬전통시유의의적。
BACKGROUND:Lateral retinacular release is effective to treat anterior knee pain, but it has not been confirmed through the parameters of the knee joint. OBJECTIVE: To analyze the relevant parameters on the axial X-ray films of the patela before and after lateral retinacular release and then to find out the efficient parameters for patelofemoral joint disorders on the axial X-ray film of the patela, which are of most clinical significance. METHODS: Fifty patients with anterior knee pain were included randomly who admitted at the Department of Joint Surgery, Affiliated Hospital of Jining Medical University from February 2009 to December 2013, including 45 cases of Outerbridge I-III undergoing arthroscopic lateral retinacular release+articular cartilage repair and 5 cases of Outerbridge IV undergoing lateral retinacular release+knee joint surface replacement. RESULTS AND CONCLUSION:After lateral retinacular release, the congruence angle, patelofemoral index and tilt angle were al reduced significantly (P < 0.05 orP < 0.01), but there was no change in the lateral patelofemoral angle (P > 0.05). The patelar trajectory restored to the corresponding central position of the femoral condyle, and meanwhile, no joint hematoma, deep vein thrombosis and patelar subluxation occurred. These findings indicate that the lateral retinacular release is of great significance for treatment of anterior knee pain induced by lateral patelofemoral compression.