关节镜下髌骨外侧支持带松解术治疗髌骨倾斜挤压综合征

Treatment of excessive lateral pressure syndrome of patella with arthroscopic lateral patella retinaculum releasing

目的探讨关节镜下髌骨外侧支持带松解术治疗髌骨倾斜挤压综合征的效果。方法对14例髌骨倾斜挤压综合征患者15个膝关节行关节镜下髌骨外侧支持带松解术。手术前后按Lysholm膝关节功能评分进行评估。屈膝20°位CT片测量手术前后髌骨倾斜角（PTA）、外侧髌股角（LPFA）。结果14例均获6-18个月随访,Lysholm评分术前为54.53分±5.54分,术后6个月为88.73分±7.0分（P〈0.01）;PTA术前为2.78°±0.40°,术后为18.53°±0.83°（P〈0.01）;LPFA术前为0.97°±0.47°,术后为8.32°±0.63°（P〈0.01）。结论关节镜下髌骨外侧支持带松解术能有效纠正髌骨倾斜,缓解疼痛,恢复膝关节运动功能,且创伤小,并发症少。

Objective To study the arthroscopic technique of lateral patella retinaculum releasing for excessive lateral pressure syndrome, and to study its clinical results. Methods 15 knees of 14 patients with excessive lateral pressure syndrome were treated with arthroscopic lateral patella retinaculum releasing. The results were evaluated according to Lyscholm rating scale before and after operation. The computed tomography scanning was done on the patients with the knee joint in 20 degrees of flexion to measure the patellar tilt angle and lateral patellofemoral angle before and after operation. Results All 14 patients were followed up for 6 - 18 months. The Lysholm knee scores were 54.53 ± 5.54 preoperatively and 88.73 ±7.0 postoperatively （P 〈0.01 ）. The patellar tilt angle were 2. 78°±0. 40°preoperatively and 18. 53° ±0. 83° postoperatively （P 〈0. 01 ）. And the lateral patellofemoral angle were 0. 97°±0.47° preoperatively and 8.32° ± 0. 63 ° postoperatively （P 〈 0. 01 ）. Conclusions The tilt of the patella can be effective corrected by arthroscopic lateral patella retinaculum releasing. The operation can alleviate pain and restore knee function with less invasion and low incidence of complication.