髌骨单隧道与双隧道重建内侧髌骨韧带的临床疗效对比

Comparison of the Clinical Curative Effects of the Patella Single Tunnel and the Double Tunnel in the Reconstruction of Medial Patella Ligament

目的:对比观察髌骨单隧道重建和双隧道重建内侧髌股韧带治疗复发性髌骨脱位的临床效果。方法:选取2010年6月~2016年5月在关节镜下行内侧髌股韧带重建治疗的47例复发性髌骨脱位患者作为研究对象,按照治疗方法的不同分为髌骨单隧道重建组22例和髌骨双隧道重建组25例,术后复查记录两组的再脱位的病例数、髌骨倾斜角和Kujala评分,进行膝关节功能评估。结果:所有患者随访12个月以上,平均随访时间39个月,无再脱位病例;治疗后两组患者的Kujala评分均较治疗前升高,差异均有统计学意义,P<0.05;而治疗后两组患者的Kujala评分相比较,差异无统计学意义,P>0.05;治疗后两组患者的髌骨倾斜角比治疗前均有缩小,差异有统计学意义,P<0.05;而治疗后两组患者的髌骨倾斜角相比较,差异均无统计学意义,P>0.05。结论:髌骨单隧道和双隧道重建内侧髌股韧带均能恢复髌骨稳定性,提高膝关节功能,两种手术方法的临床疗效无明显差异,但是单隧道重建方法简单、创伤小、手术时间更短,更利于患者恢复。

Objective： To compare the clinical curative effects of patella single tunnel and double tunnel to reconstruct the medial patellofemoral ligament in the treatment of recurrent patellar dislocation. Methods： From June 2010 to May 2016, chose 47 cases of patients with recurrent dislocation who receipted the patella reconstruction of medial patellofemoral ligament in arthroscopic as the research objects, according to the different treatment methods, they were divided into the patella single tunnel reconstruction group with 22 cases and the patella double tunnel reconstruction group with 25 cases. After the operation, recorded the number of re-dislocation, the inclination angle of patella and the Kujala scores of the two groups to evaluate the knee joint function. Results： All the patients were followed up for more than 12 months, the average followed up time was 39 months, with no dislocation cases. After the treatment, Kujala scores of two groups were higher than that before treatment, the differences were statistically significant, P 0.05; and the difference between two groups＇ Kujala score after treatment was not statistically significant, P0.05; after the treatment, the patellar tilt angle of two groups of patients were reduced, the differences were statistically significant, P0.05; and compared the two groups＇ patellar tilt angle after treatment, there were no statistically significant differences, P 0.05. Conclusion： The patella or single tunnel double tunnel reconstruction of medial patellofemoral ligament can restore the stability of patellar, improve the knee function. And the evaluation of clinical efficacy of two surgical methods has no significant difference, but compared with the double tunnel reconstruction method, single tunnel reconstruction method is simple, and with less trauma and shorter operation time, therefore, the patella single tunnel reconstruction is more conducive to clinical application.