关节镜下内侧髌股韧带紧缩并外侧髌韧带松解治疗髌股关节疼痛综合征临床对照试验

Clinical observation of arthroscopic medial patellofemoral ligament overlap and lateral patellar retinaculum release in treatment of patellofemoral pain syndrome

目的:探讨关节镜下内侧髌股韧带紧缩并外侧髌韧带松解治疗髌股关节疼痛综合征的手术疗效。方法:将100例髌股关节疼痛综合征患者随机分为治疗组和对照组各50例,男35例,女65例;年龄50～70岁,平均63岁。手术均在关节镜下进行,治疗组采用内侧髌股韧带紧缩、外侧髌韧带松解术式;对照组采用临床广泛使用单一外侧髌韧带松解手术。结果:随访平均13个月,采用HSS(hospital for special surgery)慢性疾病及关节炎评估系统评价疗效,治疗组平均积分(73.52±11.17)分;对照组平均积分(65.50±13.70)分(P<0.05)。结论:内侧髌股韧带紧缩并外侧髌韧带松解治疗髌股关节疼痛综合征临床疗效满意。与外侧髌韧带松解术式相比,更能纠正髌股关节的病理运动轨迹,使髌股关节内外侧间隙平衡更为容易,对髌前疼痛的缓解更有效,术后无关节内血肿、髌骨坏死和髌骨脱位等并发症发生。

Objective ：To explore the therapeutic results of surgical treatment for patellofemoral pain syndrome, Methods ： One hundred patients （35 males and 65 females,ranging from 50 to 70 years old with an average age of 63 years）with patellofemoral pain syndrome were randomly and equally divided into treatment group and control group. All patients underwent arthroscopic treatment. The patients in treatment group were treated with medial patellofemoral ligament overlap and lateral patellar retinaculum release,and the patients in control group were just treated with lateral patella retinaculum release which is a current widespread operation. Results.-All patients were followed-up with the mean time of 13 months, and were evaluated with HSS （hospital for special surgery） scoring system for the therapeutic effect. The mean score of treatment group （73.52±11,17 ）and control group （65.50± 13,70 ） had statistical difference （P〈0.05）, which indicated that the therapeutic effect of medial patellofemoral ligament overlap and lateral patellar retinaculum release for treatment of patellofemoral pain syndrome was satisfying. Conclusion：Compared with lateral patellar retinaculum release,this procedure is superior in correcting the abnormal movement of patellofemoral joint, easily balancing patellofemoral joint space, effectively relieving the pain of anterior knee. No postoperative complications occur, such as intraarticular haematoma, necrosis and dislocation of patella and so on.