腘绳肌腱移植包埋法重建内侧髌股韧带治疗复发性髌骨脱位

Hamstring tendon transplantation embedding reconstruction of medial patellofemoral ligament for the treatment of recurrent patellar dislocation

目的 ：探讨腘绳肌腱移植包埋法重建内侧髌股韧带治疗复发性髌骨脱位的疗效。方法 ：2008年3月至2013年6月间收治复发性髌骨脱位67例,其中男28例,女39例;年龄10-42岁,平均22岁。临床表现为膝关节不稳感,＂打软腿＂,髌骨错位感,膝前疼痛等。67例均行腘绳肌腱移植包埋法重建内侧髌股韧带。术前后采用Lysholm评分及Q角变化对疗效进行评估。结果：术后67例均获随访,随访时间4-60个月,平均（27.5±13.4）个月。术后切口均愈合良好,无髌骨脱位或半脱位发生。Lysholm评分由术前76.35±2.86提高到术后82.71±2.29;Q角从术前（18.75±2.33）°降至术后（13.28±1.75）°。结论：腘绳肌腱移植包埋方法重建内侧髌股韧带可以提供足够的张力,恢复髌骨稳定性,改善膝关节功能。

Objective：To explore the effectiveness of hamstring tendon graft embedding reconstruction of medial patellofemoral ligament for the treatment of recurrent dislocation of the patella. Methods：From March 2008 to June 2013,67 patients with recurrent dislocation of patella were treated,including 28 males,39 females with an average age of 22 years ranging from 10 to 42 years old. The clinical manifestations involved knee joint instability, ＂giving way＂,sense of patellar dislocation,anterior knee pain. All 67 patients underwent arthroscopic hamstring tendon graft embedding reconstruction of the medial patellofemoral ligament. The curative effect were evaluated by preoperative and postoperative Lysholm score and Q angle changes. Results：All cases were followed up after operation and the mean follow up time was（27.5±13.4） months（4 to 69months）. Postoperative incision were healed well and no patellar dislocation or subluxation occurred. Lysholm score improved from preoperative 76.35±2.86 to 82.71±2.29 postoperatively;Q angle decreased from preoperative（18.75±2.33）° to postoperative（13.28±1.75）°. Conclusion：The method for the reconstruction of medial patellofemoral ligament can provide enough tension,patellar stability,improving the function of knee joint.