膝关节镜下两种手术方式治疗髌骨轨迹异常的远期疗效观察.docVIP

精品论文 参考文献 膝关节镜下两种手术方式治疗髌骨轨迹异常的远期疗效观察 康斌（四川省绵阳市中心医院骨科 621000） 【摘要】目的 比较膝关节镜下两种手术方式治疗髌骨轨迹异常的远期疗效。方法 2008年6月至2012年9月间共收治髌骨轨迹异常患者32例，随机分为两组，A组(n=14例)：采用膝关节镜下髌外侧支持带松解术；B组(n=18例)：采用膝关节镜下髌外侧支持带松解联合胫骨结节内移术。比较两组患者膝关节功能及影像学变化。结果 31例患者获得随访，随访16～52个月，平均(37.13plusmn;4.35)个月。与术前相比，A、B组膝关节功能明显改善(P﹤0.05)，影像学方面，A组在髌骨适合角(CA)及外侧髌股角(LPA)方面，B组在Q角(QA)、CA及LPA方面有明显改善(P﹤0.05)。两组患者术前各项指标无统计学差异(P﹥0.05)，术后B组QA明显低于，LPA明显高于A组(P﹤0.05)，而CA、膝关节功能无统计学差异(P﹥0.05)。所有患者术后伤口I期愈合。结论 膝关节镜技术治疗髌骨轨迹异常是一种微创、有效、可靠方法，能够大幅度改善膝关节功能，且膝关节镜下髌外侧支持带松解联合胫骨结节内移术疗效更佳。 【关键词】 关节镜 髌骨轨迹异常 【中图分类号】R687 【文献标识码】A 【文章编号】2095-1752（2013）29-0028-02 The long-term theraputical effect of two knee arthroscopic surgery for patellofemoral malalignment 【Abstract】 Objective To compare the long-term theraputical effect of two knee arthroscopic surgery for patellofemoral malalignment. Methods Knee arthroscopic surgery was performed in 32 patients with patellofemoral malalignment from June 2008 to September 2012 in our hospital. Two methods were applied: (1)Group A: lateral patella retinaculun, (2)Group B: lateral patella retinaculun plus tibial tubercle anteromedial transfer. Clinical function and radiographic imaging of knee were used to evaluate the efficacy during the follow-up. Results 31 patients were followed up. According to HSS, clinical function of knee after arthroscopic surgery in both groups had improved significantly, compared to that before surgery(P﹤0.05). Radiological results had also improved(P﹤0.05). After surgery, QA in Group B were lower, LPA was higher than those in Group A(P﹤0.05). However, no difference in CA, clinical function(P﹥0.05). All surgical incisions recovered with classⅠhealing. Conclusion Knee arthroscopic surgery is a reliable treatment method for patellofemoral malalignment, with more favorable results for lateral patella retinaculun plus tibial tubercle anteromedial transfer. 【Key words】 Arthroscopic surgery Patellofemoral malalignment 髌骨轨