伸膝装置延长治疗复发性髌骨脱位

Lengthening of Extensor Apparatus of the Kneefor the Surgical Treatment of Recurrent dislocation ofthe Patella

作者报告了伸膝装置延长结合综合手术措施治疗复发性髌骨脱位２４例（２７膝）。随访１４～１３０个月，平均３８个月。脱位无复发，无膝痛，蹲起自如，效果极为满意。作者认为伸膝装置挛缩变短是复发性髌骨脱位的重要病理改变之一。以往手术治疗复发率高，膝关节功能障碍和髌股关节骨关节炎的发生均与伸膝装置挛缩有关。本方法可使伸膝装置恢复至接近正常长度和张力，使髌股关节压力减轻，提高髌骨的稳定性，对于复发性髌骨脱位这是一种有效的治疗措施。

AbstractLengthening of the quadriceps tendon and routinesurgical procedures for the treatment of recurrent dis-location of the patella(RDP)were carried out in 24 pa-tients(27 knees).All patients were followed-up foran average of 38 months(range 14～130 months).There were no redislocation and no pain in the kneejoint.All of the patients were able to squat down andto stand up freely.The authors emphasized the con-tracture of the extensor apparatus being one of themain pathological changes in RDP. A nearly normallength and tension of the extensor apparatus can be re-covered following the authors’ surgical procedure. Thepressure of the patellofemoral joint was reduced andthe stability of the patella was enhanced. Complica-tions such as redislocation of the patella,dysfunctionof the knee joint and osteoarthritis of thepatellofemoral joint were not uncommon after the op-eration.The authors considered that,all these compli-cations were related to the contracture of the quadri-ceps apparatus.The reported surgical procedures forRDP are eHective and can avoid all the above men-tioned complications.