关节镜辅助下髌骨脱位后内侧髌股韧带重建两种方法效果对比

Comparison of two ways of arthroscopic reconstruction of medial patellofemoral ligament after patellar dislocation

目的 比较关节镜辅助下髌骨脱位后重建内侧髌股韧带的两种方法的效果.方法 对2011年1月至2014年7月收治的髌骨脱位患者53例行关节镜检查,对其中24例采用髌骨侧“L”型骨隧道固定法,29例采用髌骨侧带线锚钉固定法,经软组织隧道引至股骨侧,可吸收胫骨挤压螺钉固定.术后定期随访,在可调节支具保护下行功能锻炼.结果 53例患者全部定期随访6-12个月,平均8.7个月;膝关节功能活动完全正常50例,屈曲功能有所受限2例,行关节粘连松解术后仍屈曲受限1例;术后Lyscholm膝关节评分为（92.69±2.66）、（93.17±2.51）分,均较术前明显提高（P〈0.01）,组间比较差异未见统计学意义（P〉0.05）.结论 两种手术方式对于重建内侧髌股韧带均为很好的方法,且在治疗髌骨脱位术后固定效果方面未见明显差异.

Objective To compare the effect of two ways of arthroscope reconstruction of medial patellofemoral ligament after patellar dislocation.Methods From January 2011 to July 2014,53 patients with patellar dislocation were selected.Arthroscopic examination was performed in 53 patients.Among them,24 cases were treated by patellar lateral ‘ L’ type bone tunnel fixation,and 29 cases were treated by patellar lateral line anchor screw fixation.The soft tissue tunnel leaded to the femoral side,the tibial compression screw fixation can be absorbed.After the operation and regular follow-up,the patients under the adjustable support for the protection of the downward functional exercise.Results All of the 53 patients were followed up for 6 to 12 months,average 8.7 months.Fifty cases were completely normal in the knee joint function activities,two cases had limited flexion function,and one case was still limited after the adhesion lysis.Postoperative Lyscholm knee scores were 92.69 ± 2.66,93.17 ± 2.51,compared with the preoperative,they were significantly improved（P 〈 0.01）.There was no significant difference between the two groups （P 〉 0.05）.Conclusions The two ways of surgical methods for the reconstruction of the medial patellofemoral ligament are good methods,and in the treatment of patellar dislocation after fixed effects has no significant difference.