关节镜下外侧支持带松解治疗髌股关节骨性关节炎

Treatment of patellofemoral joint osteoarthritis with arthroscopic lateral retinacu * lar release

目的:探讨关节镜下外侧支持带松解治疗髌股关节骨性关节炎的早期疗效及相关问题。方法:32膝X线证实髌骨倾移的髌股骨性关节炎患者在关节镜下射频汽化仪进行关节清理术结合外侧支持带松解术。手术前后测量髌骨内侧推移度、髌骨轴位片角度、用Kujala髌股关节评分法比较髌股关节功能改善情况。术后随访。结果:术前髌骨固定者10例,手术前后根据Kujala髌股关节评分法分别为50.80±7.13分和66.30±4.00分,术后髌骨内侧推移改善0.83±0.14cm。髌骨活动小于1/2象限者12例,手术前后根据Kujala髌股关节评分法分别为59. 75±5.01分和79.69±10.47分。手术前后髌骨内侧推移改善0.33±0.07cm和1.05±0.15cm。髌骨活动小于1象限者10例,手术前后根据Kujala髌股关节评分法分别为60.01±4.99分和75.20±6.11分。手术前后髌骨内侧推移改善0.60±0.08cm和1.15±0.17cm。结论:关节镜下射频汽化仪进行关节清理术结合外侧支持带松解术,可有效恢复髌骨内侧活动度及髌股关节的对合,改善髌股关节的功能。

Objective： To explore the therapeutic early efficacy and related issues of patellofemoral joint osteoarthritis with arthroscopic lateral retinacular release. Methods：32 knees who were confirmed to patellar tilt of the patellofemoral arthritis by radiographic methods ,were treated with arthroscopic radiofrequency debridement and lateral retinacular release. Before and after surgery measured the patellar medial glide test,the patella the axial of angle and the Patient were assessed using the Kujala patellofemoral score. Results：Preoperative patella were fixed in 10 cases. The patellofemoral joint score was improved 50.80 ± 7.13 preoperatively and 66.30 ± 4.00 postoperatively, after surgery The patellar medial glide test was improved 0.83 ± 0. 14cm. The patellar medial glide test were less than one quadrant 12 cases. The patellofemoral joint score was improved 59.75 ± 5.01 preoperatively and 79.69 ± 10.47 postoperatively , The pateUar medial glide test 0.33 ± 0.07cm preoperatively and 1.05 ± 0.15cm postoperatively. The patellar medial glide test were less than one quadrants 10 cases. The patellofemoral joint score was improved 60.01 ± 4.99 preoperativeIy and 75.20 ± 6.11 postoperatively, The pa- tellar medial glide test 0.60 ± 0.08cm preoperatively and 1.15 ±0. 17cm postoperatively. Conclusion： The arthroscopic radiofrequency debridement and lateral retinacular release Can be an effective restoration of the patellar medial glide test and improve alignment. The patient would achieve better patellofemoral joint function.