急性髌骨脱位的关节镜治疗

The arthroscopic treatment of acute dislocation of patella

目的探讨关节镜辅助治疗急性髌骨脱位的疗效。方法对15例急性髌骨脱位患者结合临床表现、骨骺闭合、TT-TG值等情况,采用关节镜辅助下清理术、外侧支持带松解、内侧关节囊重叠缝合、内侧髌股韧带重建及胫骨结节内移术等不同术式联合治疗。手术前后采用Lysholm评价表进行评分。结果患者均获得随访,时间4～20(15±2.3)个月。Lysholm评分术前(65.00±11.35)分,术后改善至(91.27±4.17)分,差异有统计学意义(P<0.05)。术后无髌骨再脱位发生,髌骨倾斜和恐惧试验均阴性。结论对急性髌骨脱位患者,结合具体病情,采用关节镜辅助下不同手术联合方案,可收到良好疗效。

Objective To explore the clinical effects of arthroscopically assisted treatment of acute dislocation of pa- tella. Methods According to clinical situation, osteoepiphysis line conditions, the value of TF-TG and so on,differ- ent surgical procedures were performed on 15 patients with acute patellar dislocation,including joint debridement, lat- eral retinacular release and medial capsule overlap suture, medial patellofemoral ligament reconstruction and antero- medial tibial tubercle transfer. Knee function was evaluated by Lysholm score preopratively and postopratively. Re- sults All cases were followed up for 4 - 20 （ 15± 2.3） months. No patellar dislocation occurred postoperatively. Apprehensive test and patella tilt test were all negative; Lysholm＇s score were （65.00 ± 11.35） points preoperatively and （91.2 ± 4. 17） points postoperatively （P 〈 0. 05）. Conclusions Based on patient b specific conditions, the dif- ferent combined surgical procedures assisted by arthroscopy can effectively cure acute dislocation of patella.