关节镜下五联手术治疗髌股关节外侧高压综合征

Lateralhigh Pressure Syndrome of Patellofemoral Joint Treated with Five Joint Operation under Arthroscopy

目的探讨分析关节镜下五联手术治疗髌股关节外侧高压综合征(ELPS)的临床疗效。方法选取昆明市第二人民医院骨关节中心自2017年1月至2019年1月之间收治的外侧髌股关节高压综合征患者26例作为本研究对象,所有患者均采取关节镜下炎性滑膜及损伤软骨清理、髌骨外侧支持带松解、损伤骨软骨微骨折、髌骨外侧面成型、髌股关节周围去神经化五联手术治疗外侧髌股关节高压综合征,并对所有治疗的患者进行1个月至一年半的随访,采用视觉模拟评分法观察本组患者在治疗前及治疗后膝前痛的情况,采用膝关节Lysholm功能评分对患者进行对比分析,并行膝关节正侧位X线和CT来明确髌骨位置的改变,评定膝关节功能恢复情况。结果经过随访调查,26例患者膝前痛症状较术前得到明显改善,治疗前平均VAS评分为(5.12±0.28),治疗后为(2.11±0.32),经对比差异有统计学意义(P<0.05);术前膝关节Lysholm功能评分(47.53±2.2)分,术后(82.13±9.42)分,经对比差异具有统计学意义(P<0.05)。术后CT检查显示患者髌股关节间隙狭窄改善,髌骨外倾较术前纠正。结论关节镜下炎性滑膜及损伤软骨清理、髌骨外侧支持带松解、损伤软骨微骨折、髌骨外侧面成型、髌股关节周围去神经化关节镜下五联手术治疗外侧髌股关节高压综合征可以取得可靠的临床疗效,能够明显的缓解膝前痛及改善膝关节的功能,值得在临床上进行推广使用。

Objective To explore and analyze the clinical effect of five joint arthroscopic surgery on lateral patellofemoral high pressure syndrome(ELPS).Me thods We selected 26 patients with patellofemoral joint high-pressure syndrome admitted in our hospital from January 2017 to January 2019 as the object in this study,all patients were taken under arthroscopy inflammatory synovium and cartilage injury of cleaning,patellar lateral retinaculum and release,bone cartilage injury,patellar lateral to forming,micro fracture around the patellofemoral joint denervation,immovable surgical treatment of the lateral patellofemoral joint high pressure syndrome,and all patients were followed up for 1 months to a year and a half,the visual analogue scale method was adopted to observe the patients before treatment and after treatment of knee pain,Lysholm function score of knee joint was used for comparative analysis of patients,and X-ray and CT of knee joint were used to identify changes in patella position and assess the recovery of knee joint function.Re s ults After follow-up investigation,the symptoms of knee pain in 26 patients were significantly improved compared with those before surgery.The average VAS score before and after treatment was(5.12±0.28),and(2.11±0.32),respectively.The difference was statistically significant(P<0.05).Lysholm function score of knee joint was(47.53±2.2)before and(82.13±9.42)after surgery,and the difference was statistically significant(P<0.05).Postoperative CT examination showed that the patellofemoral space stenosis of the patient was improved and the patellar extraversion was corrected compared with the preoperative correction.Conclus ions The inflammatory synovium and cartilage injury under arthroscopy cleaning,patellar lateral retinaculum release,the lateral aspect of patella cartilage damage micro fracture,molding,patellofemoral joint around to nerve under arthroscopy immovable surgical treatment of the lateral patellofemoral joint syndrome can get reliable clinical curative effect on high pressure,can obviously relieve knee pain and improve the function of the knee joint,is worth popularizing in clinical use.