股薄肌肌腱重建内侧髌股韧带治疗复发性髌骨脱位的临床效果

Clinical effect of reconstruction of medial patellofemoral ligament with recursive patellar tendon on recurrent patella dislocation

目的探讨股薄肌肌腱重建内侧髌股韧带（MPFL）治疗复发性髌骨脱位的效果及对患者SF-36评分的影响。方法将2014年10月至2016年10月郑州市骨科医院60例复发性髌骨脱位患者随机分为两组，对照组患者给予保守治疗，实验组患者给予股薄肌肌腱重建内侧髌股韧带治疗。比较两组患者髌骨参数、髌股关节功能、并发症与SF-36评分。结果实验组患者治疗后髌股合适角（CA）、髌骨倾斜角（PTA）与胫骨结节一滑车间距（TY-TG）水平均低于对照组，Kujala评分、Lyshlom评分与IKDC评分均高于对照组。治疗后生理功能（PF）、生理职能（RP）、躯体疼痛（BP）、总体健康（Gn）、活力（VT）、社会功能（sF）、情感职能（RE）与心理健康（MH）评分均高于对照组，差异有统计学意义（P〈0．叭）；两组患者治疗期间并发症差异未见统计学意义（P〉0．05）。结论股薄肌肌腱重建内侧髌股韧带治疗复发性髌骨脱位的效果显著，可提升SF-36评分，具有借鉴意义。

Objective To investigate the effect of medial patellofemoral ligament （MPFL） on recurrent patellar dislocation and its effect on SF-36 score of patients. Methods Sixty patients with recurrent patellar dislocation were randomly divided into two groups from October 2014 to October 2016 in Zhengzhou Orthopedic Hospital. The patients in control group were treated by conservative treatment, the patients in experimental group were treated by medial patellofemoral ligament. The patellar parameters, patellofemoral function, complications and SF-36 score were compared between the two groups. Results The levels of CA, PTA and TF-TG were lower, Kujala scores, Lyshlom scores and IKDC scores were significantly higher in experimental group than those in control group after treatment （ P 〈 0.01 ）. The PF, RP, BP, GH, VT, SF, RE and MH scores were higher in experimental group than those in control group after treatment （P 〈 0. 01 ）. There was no significant difference in the incidence of complications between the two groups during treatment （ P 〉 0.05 ）. Conclusions The reconstruction of the medial patellofemoral ligament with the femoral muscle tendon is effective on recurrent patellar dislocation, which can improve the SF-36 score, and is of reference siznificanee.