关节镜下外侧支持带松解治疗髌骨外侧过度挤压综合征合并氟骨症

Treatment for Patients with Lateral Patellar Compression Syndrome Combined with Skeletal Fluorosis by Arthroscopic Lateral Retinacular Release

目的:探讨关节镜下外侧支持带松解治疗髌骨外侧过度挤压综合征合并氟骨症的疗效。方法:35例(60膝)经非手术治疗无效的髌骨外侧过度挤压综合征合并氟骨症患者,行关节镜探查及外侧支持带松解,比较患者手术前后髌骨倾斜角(PTA)和外侧髌骨角(LPFA),随访术后3月时VAS疼痛评分及WOMAC骨性关节炎指数评分、随访1年时膝关节功能Lysholm评分,并与术前比较,评价疗效。结果:术后3月时,髌骨外侧过度挤压综合征合并氟骨病患者PTA角、LPFA角低于手术前,髌骨内侧推移度则高于手术前(P<0.05),术后3个月所有膝关节疼痛减轻或消失,VAS、WOMAC评分低于术前(P<0.05);术后1年Lysholm评分高于术前(P<0.05),优良率为90.0%。结论:关节镜探查及外侧支持带松解术是治疗合并有氟骨症的髌外侧挤压综合征的有效措施,疗效明确。

Objective： To explore curative effect of arthroscopic lateral retinacular release in the treatment of patients who suffer from lateral patellar compression syndrome combined with skeletal fluorosis. Method： 35 patients（ 60 knees） of excessive lateral patellar pressure syndrome combined with skeletal fluorosis were enrolled in this study. All these patients underwent arthroscopic probe and lateral retinacular release. Comparison of patellar tilt angle（ PTA） and lateral patellar angle（ LPFA） before and after surgery were conducted. Visual analogy score（ VAS） and WOMAC osteoarthritis Index were were evaluated in follow-up after 3 months,and Lysholm score was collected in follow-up after 1year. VAS scores,WOMAC scores and Lysholm scores were compared between before surgery and after surgery. Results： 3 months after surgery,the PTA and LPFA were significantly lower than before surgery,and medial patella movement degree was significantly higher than before surgery（ P〈0. 05）.3 months after surgery,all pain of knee relieved or disappear,and VAS scores and WOMAC scores were significantly lower than before surgery（ P〈0. 05）. 1 year after surgery,Lysholm score was higher than before surgery,and the excellent and good rate was 90%. Conclusion： Arthroscopic probe and lateral retinacular release is an effective mothod in the treatment of lateral patellar compression syndrome combined with skeletal fluorosis and its curative effect is clear.