【摘要】 目的 探讨胫骨结节远端内侧移位联合内侧髌股韧带重建和（或）外侧支持带松解治疗J形征阳性复发性髌骨脱位的短期临床疗效。方法 回顾性分析自2020-01—2022-05采用手术治疗的14例J形征阳性复发性髌骨脱位（股骨前倾角<30°，Caton指数>1.2），进行胫骨结节远端内侧移位、内侧髌股韧带重建和（或）外侧支持带松解。结果 14例均获得随访，随访时间18～26个月，平均19.8个月。术后所有患者J形征消失，髌骨恐惧试验阴性，随访期间未出现髌骨再脱位。末次随访时TT-TG间距为8～15 mm，平均12.1 mm;Caton指数为0.96～1.13，平均1.06;Tegner评分为5～9分，平均6.8分；Kujala评分为84～95分，平均89.4分；Lysholm评分为90～95分，平均92.4分；疼痛VAS评分为0～2分，平均0.8分。结论 胫骨结节远端内侧移位联合内侧髌股韧带重建和（或）外侧支持带松解治疗股骨前倾角<30°合并高位髌骨（Caton指数>1.2）的J型征阳性复发性髌骨脱位可以获得良好疗效，消除了J形征和疼痛症状，降低了内侧髌股韧带的失效率，明显恢复膝关节运动功能。更多还原

【Abstract】 Objective To explore the short-term clinical efficacy of medial displacement of distal tibial tubercle combined with medial patellofemoral ligament reconstruction and/or lateral retinaculum release in the treatment of recurrent patellar dislocation with positive J-sign.Methods A retrospective analysis was conducted on 14 cases of recurrent patellar dislocation with a positive J-sign(femoral anteversion angle <30°, Caton index >1.2) treated with surgery from January 2020 to May 2022. The surgical procedures included medial displacement of distal tibial tubercle, medial patellofemoral ligament reconstruction and/or lateral retinacular release.Results All 14 cases were followed up for 18 to 26 months, with an average of 19.8 months. After the operation, the J-sign disappeared in all patients, and the patellar apprehension test was negative. No patellar dislocation occurred during the follow-up period. At the last follow-up, the TT-TG interval was 8 to 15 mm, with an average of 12.1 mm; the Caton index was 0.96 to 1.13, with an average of 1.06; the Tegner score was 5 to 9 points, with an average of 6.8 points; the Kujala score was 84 to 95 points, with an average of 89.4 points; the Lysholm score was 90 to 95 points, with an average of 92.4points; and the pain VAS score was 0 to 2 points, with an average of 0.8 points.Conclusion Medial displacement of distal tibial tubercle combined with reconstruction of the medial patellofemoral ligament and/or release of the lateral retinaculum can achieve good therapeutic effects in the treatment of J-sign positive recurrent patellar dislocation with femoral anteversion angle <30° and high patella(Caton index >1.2), eliminate the J-sign and pain symptoms, reduce the failure rate of the medial patellofemoral ligament, and significantly restore the knee joint’s motor function.更多还原