关节镜下髌骨支持带调整术治疗儿童复发性髌骨脱位

Arthroscopic patellar retinaculum adjustment in the treatment of children with recurrent patellar dislocation

目的探讨膝关节镜下外侧支持带松解联合内侧支持带紧缩术治疗儿童复发性髌骨脱位的疗效。方法 12例16膝髌骨脱位患儿,所有患膝均行关节镜下用等离子刀松解外侧支持带联合内侧支持带紧缩术。观察术后效果。结果术后随访12～36个月,平均随访23.5个月。术前和末次随访IKDC膝关节功能评分分别为（35.4±4.4）分和（90.1±5.3）分;Lysholm膝关节功能综合评分分别为（43.0±5.8）分和（95.7±4.2）分;Tegner下肢运动能力主观评分分别为（3.4±1.7）分和（8.7±0.9）分及患膝NRS疼痛评分分别为（8.9±0.8）分和（2.4±1.2）分,差异均具有统计学意义（P〈0.05）。结论膝关节镜下外侧支持带松解联合内侧支持带紧缩术对治疗儿童复发性髌骨脱位有明显效果,术后膝关节功能、下肢运动功能及膝关节疼痛程度较术前均有明显改善,手术疗效满意。

Objective To investigate the curative effect of arthroscopic outside retinaculum release combined with inside retinaculum compression in the treatment of children with recurrent patellar dislocation. Methods There were 12 children with patellar dislocation in 16 knees, and all patients received arthroscopic outside retinaculum release combined with inside retinaculum compression by plasma knife. Observation was made on postoperative effect. Results Follow-up was taken for 12～36 months, with the average time as 23.5 months. IKDC knee joint scores were（35.4±4.4） points and（90.1±5.3） points before operation and in the last follow-up. Tegner lower limb movement ability subjective ratings were（3.4±1.7） points and（8.7±0.9） points. NRS pain scores were（8.9±0.8） points and（2.4±1.2） points. The difference had statistical significance（P0.05）. Conclusion Arthroscopic outside retinaculum release combined with inside retinaculum compression in the treatment of children with recurrent patellar dislocation can provide precise effect, and bring obvious improvements in knee joint function, lower limb motor function and knee pain degree with satisfactory surgical effect.