髌骨脱位行内侧髌骨股骨韧带重建术后的康复治疗

Research of rehabilitation therapy on patients with dislocation of patella after medial patellofemoral ligament reconstruction

目的:探讨内侧髌骨股骨韧带(MPFL)重建术后髌骨脱位患者康复治疗方法,最大程度恢复膝关节功能。方法:50例MPFL重建术后的髌骨脱位患者随机分成治疗组和对照组,每组各25例。治疗组给予等速肌力训练等综合康复,对照组进行指导回家自行训练,术后第12、24周对两组患者进行等速测试(慢速60°/s、快速180°/s),并将股四头肌及股内侧肌患侧/健侧峰力矩百分比、膝关节活动度(ROM)及Lysholm膝关节评分进行比较。结果:治疗组术后第12、24周,股四头肌患侧/健侧峰力矩百分比慢速分别为61.19±4.80、83.08±2.52,快速分别为68.62±5.04、90.85±1.82,股内侧肌百分比慢速分别为73.19±6.27、91.73±8.11,快速分别为68.49±2.64、82.42±4.12,Lysholm评分分别为82.36±2.57、95.79±1.03,均优于对照组(P<0.05),ROM分别为138.31±4.79、141.72±5.16,与对照组差异无显著性(P>0.05)。结论:该方案能成功应用于MPFL重建的髌骨脱位患者术后的康复,并取得良好的效果。

Objective： To explore the rehabilitation therapy for dislocation of patella after medial patellofemoral ligament （MP- FL） reconstruction to regain the knee function maximally. Method： Fifty patients after MPFL reconstruction, were randomly divided into treatment group and control group, each group 25 cases. The treatment group received comprehensive rehabilitation, and the control group received medical instruction, then self-exercise. After 12 and 24 weeks postoperation, subjects were assessed with isokinet- ic measurement, and the involved/uninvolved peak torque ratio of quadriceps femoris and medial vastus muscle, range of motion （ROM） of knee joint and Lysholm score. Result： After 12 and 24 weeks postoperation, the peak torque ratio of treatment group＇s quadriceps femoris on low-speed were 61.19 ＋ 4.80, 83.08 ＋ 2.52, on high-speed were 68.62 ~ 5.04, 90.85 ~ 1.82; and which of medial vastus muscle on low-speed were 73.19 ~ 6.27, 91.73 ~ 8.11, on high-speed were 68.49 ~ 2.64, 82.42 ~ 4.12; Lysholm scores were 82.36 ~ 2.57, 95.79 ~ 1.03, were superior to that of control group （P〈0.05）; ROM were 138.31 ~4.79,141.72~5.16, no significant difference with control group（P〉0.05）. Conclusion： The therapy can be applicable to patients with dislocation of patella after MPFL reconstruction and it＇s effectiveness is obviously. Author＇s address The Department of Rehabilitation Medicine, Beijing Jishuitan Hospital, Beijing, 100035