外侧结构松解治疗轻、中度习惯性髌骨脱位:一项回顾性临床研究

Lateral Structure Release for the Treatment of Mild to Moderate Habitual Dislocation of Patella:A Retrospective Study

目的:探讨外侧结构松解治疗轻、中度习惯性髌骨脱位(HDP)的临床疗效。方法:2010年4月至2014年4月,共51例习惯性髌骨脱位患者接受手术治疗,符合入选标准的患者23例。全部患者采用外侧结构松解手术,包括单纯髌骨外侧支持带松解、外侧支持带松解合并股外侧肌松解,其他辅助手术包括内侧髌骨股骨韧带(MPFL)重建和胫骨结节內移截骨术。术后4周、8周、1年以及此后的每年进行主客观临床评估和影像学评估。结果:共21例患者获得2年以上随访,平均年龄为25.0±7.4岁(17至38岁),平均随访30.5±5.8个月(24至46个月)。单纯外侧支持带松解术占42.9%(9/21),外侧支持带合并股外侧肌松解术占57.1%(12/21)。术后及末次随访时均没有外侧再脱位。全部主观评分结果的改善均有统计学意义。结论:对于伸膝装置轻、中度短缩的习惯性髌骨脱位,采用外侧松解技术可以获得满意的疗效。

Objectives To evaluate the clinical outcome of lateral structure release in the treatmentof patients with mild or moderate habitual dislocation of patella（HDP）. Methods From 51 HDP pa-tients undergoing surgical treatment between April 2010 and 2014,23 patients were chosen and giventhe lateral structure release,including isolated lateral retinaculum release（LRR） and LRR combinedwith vastus lateralis oblique（VLO） lengthening.Other auxiliary surgeries included medial patellofemoralligament（MPFL） reconstruction and tibial tubercle medialization. Radiological,objective and subjectiveevaluations were performed at 4 and 8 weeks,as well as and 1 year after the surgery and every yearafterwards. Results There were 21 patients followed for a minimum of 2 years. Their average age was25.0 ± 7.4 years（ranging from 17 to 38 years old）,and the mean follow-up period was 30.5 ±5.8 months（ranging from 24 to 36 months）. Isolated LRR was performed in 42.9%（9/21） of the pa-tients,and LRR combined with VLO lengthening was performed in 57.1%（12/21） of them. No redisloca-tion was reported. Significant improvement was observed in the subjective evaluation score. Conclusions For patients with mild to moderate HDP,lateral structure release can achieve satisfactory results.