关节镜辅助下自体肌腱重建内侧髌股韧带治疗复发性髌骨脱位疗效-外科学(骨外科)专业论文.docxVIP

遵义医学院硕士学位论文仲鹤鹤 遵义医学院硕士学位论文 仲鹤鹤 PAGE PAGE 2 关节镜辅助下自体肌腱重建内侧髌股韧带治疗复发性髌骨脱位 的疗效 中文摘要 目的：探讨胫骨结节内移垫高截骨联合内侧髌股韧带重建和关节镜下外侧支持 带松解 3 联手术治疗复发性髌骨脱位 1 年后的近期疗效。 方法：对 34 例复发性髌骨脱位患者(男 6 例，女 28 例)，行胫骨结节内移垫高 截骨联合内侧髌股韧带重建和关节镜下外侧支持带松解 3 联手术治疗，术中先在镜下 检查髌骨轨迹，手术前后膝关节 CT 扫描测量髌股适合角、髌骨倾斜角及髌骨外移率 以及 Kujala、Lysholm 和 Tegner 运动功能评分评估膝关节功能。 结果：最后 6 例失访，28 例患者获得随访，随访时间 12 月~33 月，平均 18.5 月，最后随访时膝关节症状得到改善，CT 检查髌骨适合角、髌骨倾斜角及髌骨外移 率分别由术前的(33.85±4.30)°、(12.23±1.78)°、(47.7±2.61)降低到(11.58 ±1.86)°、(8.35±1.52)°、(8.8±1.63)，均有统计学差异（P=0.000）；Kujala、 Lysholm 和 Tegner 运动功能评分分别由术前的(57.7±2.93)、(56.3±2.53)、(3.4 ±0.94)分提高到(89.9±2.87)、(91.4±2.06)、(5.2±1.07)分，均有统计学差异 （P=0.000）。 结论：胫骨结节内移垫高截骨联合内侧髌股韧带重建和关节镜下外侧支持带松 解能有效治疗复发性髌骨脱位，改善膝关节的稳定性并避免脱位复发，利于患者膝关 节功能恢复。 关键词 关节镜；截骨术；内侧髌股韧带；复发性髌骨脱位 Arthroscopic reconstruction of medial patellofemoral ligament reconstruction with autogenous tendon for the treatment of recurrent dislocation of the patella Abstract Objective To discuss 1 year later ， the recent curative effect of tibial tubercle anteromedial transfer,medial patellofemoral ligament reconstruction and arthroscopic lateral retinaculum release in treating recurrent patella dislocation. Methods 28 cases recurrent patella dislocation were treated by tibial tubercle anteromedial transfer，medial patellofemoral ligament reconstruction and arthroscopic lateral retinaculum release,and all patients were probed patellar track under arthroscopy intraoperative.Knee CT scanning congruance angle preoperation and postoperation,patellar tilt angle and lateral shif,and Using the Kujala score, Lyshoim grading assessment of knee joint function score and Tegner movement. Result 6 patients were lost to follow-up，28 patients were followed for 18.5 months in average (range 12 to 33 months),knee joint symptoms improved at the last follow-up.CT scanning congruance angle,patellar tilt angle and lateral shif were respectively reduced from preoperative (33.85±4.30)° (12.23±1.78)° (47.7±2.61) to postoperative (11.58±1.86)° (8.35±1.52)° (8.