外侧支持带松解联合内侧髌股韧带重建术治疗习惯性髌骨脱位的效果

Effect of lateral retinaculum release combined with medial patellofemoral ligament reconstruction on patients with habitual patellar dislocation

目的探讨支持带松解术(外侧)联合内侧髌股韧带重建术(MPFL)治疗髌骨脱位(习惯性)的效果。方法选取2018年1月至2020年3月濮阳市人民医院习惯性髌骨脱位患者88例为研究对象。按照随机数字表法分为铆钉组与联合组,每组44例。铆钉组接受关节镜辅助带线铆钉治疗,联合组接受外侧支持带松解+MPFL治疗。比较两组术前、术后3个月膝关节活动度、Q角变化、Kujala、Lysholm评分、疼痛介质指标[一氧化氮(NO)、5-羟色胺(5-HT)]水平。结果术后3个月,联合组膝关节活动度较铆钉组高,Q角较铆钉组低(P <0.05);术后3个月联合组Kujala、Lysholm评分较铆钉组高(P <0.05);术后3个月联合组血清NO、5-HT水平较铆钉组低(P <0.05)。结论外侧支持带松解联合MPFL应用于髌骨脱位(习惯性)患者可有效改善其膝关节功能,缓解术后疼痛感,促进病情恢复,值得临床推广。

Objective To investigate the effect of retinaculum release( lateral) combined with medial patellofemoral ligament reconstruction( MPFL) on patellar dislocation( habitual). Methods A total of 88 patients with habitual patellar dislocation in Puyang People’s Hospital from January 2018 to March 2020 were selected as the research objects. According to the random number table method,they were divided into rivet group and combined group,with 44 cases in each group. The rivet group received arthroscopic assisted suture rivet treatment,and the combined group received lateral retinaculum release combined with MPFL. The changes of knee range of motion,Q angle,Kujala and Lysholm scores and the levels of pain mediators [nitric oxide( no) and 5-hydroxytryptamine( 5-HT) ] were compared between the two groups before and 3 months after operation. Results Three months after operation,the knee joint range of motion in the combined group was higher than that in the rivet group,and the Q angle was lower than that in the rivet group( P < 0. 05). The scores of Kujala and Lysholm in the combined group were higher than those in the rivet group 3 months after operation( P < 0. 05). Three months after operation,the levels of serum NO and 5-HT in the combined group were lower than those in the rivet group( P < 0. 05). Conclusions The application of lateral retinaculum release combied with MPFL in patients with patellar dislocation( habitual) can effectively improve their knee function, relieve postoperative pain and promote the recovery of the disease,which is worthy of clinical promotion.