关节镜辅助下综合方法治疗髌骨软化症48例疗效分析

Therapeutic effect analysis of chondromalacia patella treated by comprehensive method with arthroscope assisted

目的探讨治疗中重度髌骨软化症的最优方法。方法髌骨软化症患者48例56膝分为2组，分别以单纯传统外科手术方法（A组：胫骨结节抬高手术组，n=26）及关节镜下外侧支持带松解、内侧支持带紧缩加关节面打孔减压综合治疗方法（B组：关节镜综合手术组，n=30）进行治疗，随访比较疗效。结果胫骨结节抬高手术组疗效优良率61.5%，有效率69.2%；关节镜综合手术组疗效优良率86.7%，有效率93.3%。关节镜综合手术组疗效明显优于胫骨结节抬高手术组（P〈0.05）。结论关节镜辅助下综合治疗是一种较为理想的治疗髌骨软化症的方法。

Objective To investigate the optimization method of treating severe chondromalacia patella. Methods 48 cases （56 knees） chondromalacia patella patients were random divided into 2 groups： one group treated with simple traditional surgery （tibial tubercle raising group, n = 26）, the other group treated with comprehensive method which was released lateral retinaculum, stricting medial retinaculum and perforating decompression articular facet under arthroscope （arthroscopic treating group, n = 30）. The therapeutic effect were followed up and compared. Result The effect in tibia tubercle raising group achieved 61.5% good rate and 69. 2% effective power, the arthroscopic treating group achieved 86. 7% good rate and 93.3% effective power. The effect of arthroscopic treating group was obviously better than that in tibia tubercle raising group （ P 〈 0. 05）. Conclusion Comprehensive treatment with arthroscope assisted is an ideal operative method for chondromalacia patella.