膝关节镜下手术治疗髌骨半脱位疗效分析

Clinical effect of patella subluxation in knee arthroscopic examination

目的分析膝关节镜下手术治疗髌骨半脱位的临床疗效。方法回顾性分析2016年9月至2017年7月首都医科大学附属北京友谊医院连续收治的56例(66膝)髌骨半脱位患者的临床资料。其中男性24例,女性32例;年龄23~54岁,平均年龄37.9±7.1岁。该组患者均接受膝关节镜下髌骨外侧支持带松解术及髌骨内侧支持带紧缩术。术前及术后随访时分别评估膝关节疼痛视觉模拟评分(VAS)、Lysholms评分、Q角及膝关节活动范围。结果所有患者术后随访12~18个月,平均14.5个月。术后12个月随访时,VAS评分从(4.6±1.5)分降到(1.7±0.9)分(P=0.000),Lysholms评分由(72.7±8.9)分提高到(86.4±5.6)分(P=0.000),Q角由(14.6±3.2)°改变为(13.7±3.4)°(P=0.096),膝关节伸直角度由(2.6±2.1)°改变为(2.0±1.7)°(P=0.087),屈曲角度由(109.5±10.0)°改变为(117.3±9.9)°(P=0.000)。膝关节功能及疼痛明显改善。结论在膝关节镜下手术治疗髌骨半脱位创伤小、恢复快、疗效满意,是一种有效的手术方式。

Objective To investigate the clinical effect of surgical treatment of patella subluxation in arthroscopic examination. Methods The data of 56 patients (66 knees) of patella subluxation from September 2016 to July 2017 in Beijing Friendship Hospital,24 males and 32 females,were retrospective analyzed. The age range was from 23 to 54 years,with an average of 37.9 years old. All the patients underwent lateral retinaculum releasing and medial retinaculum tightening during the operations. In preoperative and follow-up period,the Visual Analogue Score (VAS),Lysholms scores,Q angle and the movement range of the knees were evaluated. Results The 56 patients were followed up for 12 to 18 months,the average follow-up period was 14.5 months. The VAS was from(4.6±1.5) to (1.7±0.9)( P =0.000). The Lysholms scores was from (72.7±8.9) to (86.4±5.6)( P =0.000).The Q angle was from (14.6±3.2)° to (13.7±3.4)°( P =0.096), the extension angle of knee joint was from (2.6±2.1)° to (2.0±1.7)°( P =0.087). The flexion angle of knee joint was from (109.5±10.0)° to (117.3±9.9)°( P =0.000) at the 12th month follow-up postoperatively. The knees function and pain improved significantly. Conclusion The treatment of patella subluxation under arthroscopy was an effective surgical method with less trauma,faster recovery and satisfactory clinical effect.