内侧髌股韧带重建治疗复发性髌骨脱位疗效观察

Clinical observation of arthroscopic assisted double bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocation

目的探讨内侧髌股韧带重建治疗复发性髌骨脱位的临床效果。方法回顾性分析湖北省荆州市中心医院2017年1月至2019年6月通过关节镜辅助下内侧髌股韧带双束重建治疗的29例复发性髌骨脱位患者的临床资料。其中,男10例,女19例,年龄14.0~29.5岁,平均19.4岁。测量TT-TG距离、髌骨倾斜角,计算Caton指数。术前、术后通过Kujala、Lysholm评分评价膝关节功能。结果所有患者均获得随访,随访时间12~36个月,术前TT-TG距离均小于20 mm、髌骨倾斜角小于20°,Caton指数0.9~1.1。所有患者术后均未见脱位复发,术前术后Kujala评分分别为(51.32±5.52)分、(82.45±3.38)分;术前、术后Lysholm评分分别为(53.25±5.85)分、(89.65±4.75)分;术前、术后髌骨倾斜角为13.15°±1.67°,6.94°±1.47°。差异均具有统计学意义(P<0.05)。结论关节镜辅助下内侧髌股韧带双束重建治疗无严重骨性异常的复发性髌骨脱位,操作简单,疗效确切,并发症少,近期随访无复发,可以显著提高膝关节功能。

Objective To investigate the clinical effect of arthroscopic reconstruction of medial patellar ligament for recurrent patellar dislocation.Methods The clinical data of 29 patients with recurrent patellofemoral dislocation treated by arthroscopic assisted double bundle reconstruction of medial patellofemoral ligament from January 2017 to June 2019 in Jingzhou Central Hospital of Hubei Province were retrospectively analyzed,including 10 males and 19 females,with an average age of 19.4 years(range,14.0-29.5 years).TT-TG distance and patellar inclination angle were measured by CT.The Caton index was calculated.Kujala and Lysholm scores were used to evaluate knee joint function before and after operation.Results All patients were followed up for 12 to 36 months.The TT-TG distance was less than 20 mm,patella tilt angle was less than 20°and Caton index was 0.9-1.1 before operation.There was no recurrence of dislocation in all patients.The preoperative and postoperative Kujala scores were(51.32±5.52)and(82.45±3.38).Lysholm scores were(53.25±5.85)and(89.65±4.75).The preoperative and postoperative patellar tilt angle was 13.15°±1.67°and6.94°±1.47°.The differences were statistically significant(P<0.05).Conclusion Arthroscopic assisted double bundle reconstruction of medial patellofemoral ligament for the treatment of recurrent patellar dislocation without serious bony abnormality is simple,effective,with few complications,and no recurrence in recent follow-up,which can significantly improve the knee joint function.