髌骨脱位治疗新篇章

New chapter in treatment of patellar dislocation

关于髌骨脱位的手术治疗方式近年来多集中在单纯的髌骨内侧支持带(MPFL)重建和创伤性较大骨性手术,如胫骨结节转位术、滑车成形术、股骨远端去旋转截骨术等。然而随着对髌股关节内侧解剖结构理解的不断加深,在髌股关节内侧限制结构中除了起水平限制作用的髌骨内侧支持带,起源于髌骨下级,斜向内下方走行的髌骨-胫骨韧带(MPTL)也同样发挥了重要的限制作用。鉴于此,本文通过回顾相关文献,总结了MPTL的解剖学、生物力学和各种重建方法,分析了MPFL联合MPTL重建治疗髌骨脱位的可行性及优势。

In recent years,the surgical treatment of patellar dislocation has mainly focused on simple reconstruction of the medial patellofemoral ligament(MPFL)and traumatic bone surgery,such as tibial tuberosity transposition,trochloplasty and distal femoral osteotomy.However,as our understanding of the anatomy of the medial patellofemoral structure increased,we found that in addition to the MPFL,which plays a role of horizontal limitation.The medial patellotibial ligament(MPTL),which originated in the lower pole of the patella and runs diagonally downward,also plays an important role of limitation.In view of this,this paper summarized the anatomy,biomechanics and various reconstruction methods of MPTL by reviewing relevant literature,and analyzed the feasibility and advantages of MPFL combined with MPTL reconstruction in the treatment of patellar dislocation.