关节镜下自体腓骨长肌腱重建内侧髌股韧 治疗复发性髌骨脱位.docVIP

关节镜下自体腓骨长肌腱重建内侧髌股韧 治疗复发性髌骨脱位 　　摘要：目的：探讨联合应用关节镜下自体腓骨长肌腱重建内侧髌股韧带治疗复发性髌骨脱位的效果。方法：对16例复发性髌骨脱位的患者，在关节镜下进行髌股外侧支持带松解术和自体腓骨长肌腱重建内侧髌股韧带。术后随访时间6-12个月，平均随访时间 8.6 个月，了解膝关节脱位复发、患膝主观症状以及患肢整体功能康复情况。结果：所有患者术后均获得满意随访，随访时间6-12个月，平均随访时间8.6个月。髌骨脱位无复发。术后X线检查对比发现，髌骨-股骨滑车适配角从术前23.2°±5.1°的改善为3.3°±3.1°（p0.01），髌骨外侧面张开角从术前的-2.1°±4.2°改善为术后的10.8°±2.8°（p0.01）。术后1年根据Insall膝关节功能评分标准，其中优11膝，良3膝，可2膝，优良率达87.5%。 结论：关节镜下进行髌骨外侧支持带松解术和自体腓骨长肌腱重建内侧髌股韧带能够有效治疗复发性髌骨脱位，防止复发，恢复膝关节功能。 　　关键词：复发性髌骨脱位；关节镜；自体肌腱；重建 　　Abstract：Objective: To investigate the effect of arthroscopic reconstruction medial patellofemoral ligament with autogenous long fibular muscle tendon for recurrent patellar dislocation. Methods: 16 cases of patients with recurrent patellar dislocation were treated with arthroscopic lateral patellofemoral retinaculum loosenin and medial patellofemoral ligament reconstruction with gautologous long fibular muscle tendon. Postoperative follow-up time 6-12 months , with an average follow-up time of 8.6 months, investigate recurrent patellar dislocation and knee limb subjective symptoms and overall functional rehabilitation. Results: All patients were satisfactory followed up for 6-12 months , with an average follow-up time of 8.6 months. No recurrence of patellar dislocation. Postoperative X-ray comparison, patella-femoral trochlear angle improve from preoperative 23.2氨5.1皌o 3.3氨3.1ng °（p0.01）, the outer surface patella opening angle from -2.1°±4.2°to 10.8°±2.8° (p 0.01). After 1 year Insall knee score based on criteria, 11 knees were excellent , 3 good knee , the excellent rate was 87.5%. Conclusion: Arthroscopic lateral patellofemoral retinaculum loosenin and medial patellofemoral ligament reconstruction with gautologous long fibular muscle tendon can effectively treat recurrent patellar dislocation , and restore knee function . 　　Keywords ：recurrent patellar dislocation ; arthroscopy ; autologous tendon ; reconstruction 　　髌骨脱位涉及许多与髌骨、股骨髁、胫骨相关的解剖因素，加上对外伤性脱位及复发性脱位的机制理解不一，在治疗上存在较大分歧。多次反复脱位可引起一系列并发症，