【作者】 夏亚一； 韵向东； 吴萌； 汪静； 汉华； 张成俊；

【Author】 Yun Xiang-Dong,Xia Ya-Yi,Wu Meng,Wang Jing,Han Hua,Zhang Cheng-Jun. Institute of Orthopaedics,Second Hospital of Lanzhou University,Lanzhou 730030,Gansu Province,China

【机构】 兰州大学第二医院骨科；

【摘要】 目的:探讨重建内侧髌股韧带治疗复发性髌骨脱位的随访研究。方法:自2007年2月至2009年9月,收集复发性髌骨脱位病例65例,男6例,女59例,年龄17～24岁,平均20岁。全部采用取自体同侧半腱肌重建内侧髌股韧带。患者手术前后用Lysholm、Tegner进行功能评分,影像学采用Congruence角、Sulcus角评分。结果:平均随访时间20月(15—23月),无患者发生膝关节髌骨半脱位或脱位。Lysholm膝关节功能评分从术前的60.6±3.74到随访时的89.8±4.58分(P<0.05),IKDC评分从术前的40±3.46分到随访时的82±3.59分(P<0.05),Tegner评分从术前的3.6±0.42分到随访时的5.6±0.35(P<0.05);Congruence角由术前的26.4°±3.9到术后的4.3°±1.82(P<0.05),Sulcus角由术前148.8°±1.97到术后140.5°±1.64(P<0.05)。结论:重建内侧髌股韧带治疗复发性髌骨脱位是一种较好的方法。更多还原

【Abstract】 Objective:The purpose of this investigation was to evaluate the prevention of patellar instability by the medial patellar stabilizers and the effectiveness of medial patellofemoral ligament(MPFL) reconstruction against lateral displacement.METHODS:During February 2007 to September 2009,65 patients including 6 male and 59 female with patellar instability underwent reconstruction of the MPFL.The reconstruction was performed using ipsilateral semitendinosis tendon to restore the damaged MPFL.Patients were evaluated pre-operatively and post-operatively by physical and subjectively with the IKDC(International Knee Documentation Committee),Tegner,and Lysholm questionnaires and radiographic examination.RESULTS:The average follow-up was 20 months(range,15-23).No recurrent episodes of dislocation or subluxation were reported. A firm endpoint to lateral patellar translation was noted in all patients at most recent follow-up.The Lysholm subjective knee evaluation score improved from 60.6±3.74 preoperatively to 89.8±4.58 postoperatively(P<.05);Tegner,from 3.6°±0. 42 to 5.6°±0.35(P<.05) and IKDC,from 40±3.46 to 82±3.59(P<.05).Radiographic evaluation demonstrated improvements in the congruence and sulcus femoral angles. CONCLUSION:MPFL reconstruction is an effective surgical procedure for the treatment of patellar instability.更多还原