关节镜下髌韧带胫骨止点修复治疗成人Osgood-Schlatter病患者的疗效分析

Arthroscopic repair of tibial insertion of patellar ligament in adult patients with Osgood-Schlatter disease

目的:探究关节镜下髌韧带胫骨止点修复治疗成人Osgood-Schlatter病(Osgood-Schlatter disease,OSD)即胫骨结节骨骺炎患者的临床疗效。方法:回顾性分析20例OSD患者的临床资料。所有患者均经关节镜下病损清除,同时接受锚钉缝合修复髌韧带胫骨止点方法的治疗。记录患者术前与术后随访的疼痛视觉模拟量表评分、膝关节活动度、Kujala髌股关节评分和Lysholm膝关节功能评分,再通过统计学分析评估该手术方法的临床疗效。结果:20例患者术后均获随访(6~12个月,平均8.4个月),且术后均无伤口感染等并发症。患者术后疼痛较术前有明显改善,视觉模拟量表评分从术前平均4.6分降至术后平均2.1分;Kujala髌股关节评分从术前平均83.2分提高到末次随访时的平均97.4分,Lysholm膝关节功能评分从术前平均82.1分提高到末次随访时的平均96.4分(均P<0.01)。结论:关节镜下髌韧带胫骨止点修复治疗OSD的创伤小,患者术后恢复快,有利于患者膝关节功能的恢复。

Objective:To investigate the clinical effect of arthroscopic patellar ligament tibial insertion repair in the treatment of adult patients with Osgood-Schlatter disease(OSD,i.e.epiphysitis of tibial tuberosity).Methods:The clinical data from 20 patients with OSD were retrospectively analyzed.All patients underwent arthroscopic lesion removal and repairing of the tibial insertion of patellar ligament by anchor.Visual analogue scale(VAS)score,knee range of motion,Kujala patellofemoral joint score and Lysholm knee function score were recorded before and after operation and the clinical effect of this surgical method was evaluated by statistical analysis.Results:All the 20 patients were followed up for 6-12 months(average 8.4 months).There were no complications such as wound infection.The postoperative pain was significantly improved compared with that before operation,the VAS score decreased from 4.6 to 2.1(P<0.01).The average score of Kujala patellofemoral joint increased from 83.2 to 97.4 at the final follow-up(P<0.01).The mean preoperative Lysholm knee function score was 82.1 and increased to 96.4 at the last follow-up(P<0.01).Conclusion:Arthroscopic repair of patellar ligament tibial insertion for the treatment of OSD has less invasive and rapid recovery and is of benefit to the functional recovery of knee joint.