【摘要】 [目的]探讨膝关节外侧支持带松解前后髌骨轨迹的变化,寻找外侧支持带松解术后部分病例效果不佳的原因。[方法]临床采集符合纳入标准的92例(138膝)样本,松解前后分别行10°、20°、30°和40°屈膝位髌股关节CT扫描,测量髌股适合角,髌骨外移角和股骨远端内侧扭转角,比较松解前后髌骨轨迹的变化。[结果]通过测量髌股适合角,髌骨外移角发现髌骨轨迹29膝松解后无改善,109膝明显改善。109膝的股骨远端内侧扭转角均>9°,29膝的股骨远端内侧扭转角均<9°。说明股骨远端内侧扭转角可能是影响外侧支持带松解后髌骨轨迹的一个重要因素。[结论]外侧支持带松解术是治疗髌股关节紊乱症非常有效的手术,但是术后部分病例效果并不理想,尤其是长期随访效果,其中原因并不明了,通过实验发现术后髌骨轨迹未发生改变可能是主要的原因,而股骨远端扭转可能是影响髌骨轨迹恢复的重要因素。更多还原

【Abstract】 [Objective] To analyze the improvement in patellar tracking after lateral patellar retinacular release and to determine the reasons for unsatisfactory outcomes during the follow- up. [Methods] Ninty- two cases( 138 consecutive knees),which had undergone isolated lateral retinacular release,were included in the study. CT scans of each knee were performed before and after surgery with the knee at different degrees of dynamic flexion 10°,20°,30°,and 40°. The following parameters were evaluated: femoral distal medial torsion angle, patellar congruence angle, and patellar lateral translation angle. Preoperative and postoperative measures of patellar tracking were compared. [Results] Patellar tracking was not improved in 29 knees after surgery. Patellar tracking was improved in 109 knees after surgery. The improvement in patellar tracking did not reach the preoperative prediction when the femoral distal medial torsion angle was less than 9°. The femoral distal medial torsion angle was found to be an important factor influencing patellar maltracking recovery. [Conclusion] Lateral retinacular release resulted in excellent results in a short- term because of decreased patellofemoral joint pressure and improved patellar tracking. The study showed that abnormal patellar track hadn’t improve after surgery amd may underlie unsatisfactory outcomes in some patients at a long- term follow- up. Meanwhile,the FMTA could be an important factor influencing patellar maltracking recovery.更多还原