关节镜下外侧支持带松解内侧支持带紧缩治疗急性髌骨脱位

目的:评价关节镜下治疗急性髌骨脱位的疗效。方法:自2010年7月至2012年6月共收治急性髌骨脱位患者28例。术前对所有患者进行放射学检查,测量Q角和全身关节松弛度。全部手术均在关节镜监视下施行。首先进行全面的关节内探查,然后取出游离的软骨和骨软骨碎片,修整损伤的软骨面,最后松解外侧支持带以及紧缩缝合内侧支持带。结果:所有病例均获得随访,随访时间0.5～2.5年,平均1.1年,均未发生感染等严重并发症。随访期内无一例复发脱位。Lysholm评分由术前的(78.2±4.6)分提高至(92.3±2.5)分,差异有统计学意义(P<0.01)。结论:关节镜手术是诊断和治疗急性髌骨脱位的优良方法,操作简便,疗效可靠。

Arthroscopic Treatment of Acute Patellar Dislocation by Lateral Patellar Retinaculum Release and Medial Patellar Retinaculum Reefing

Objective To evaluate the efficacy of arthroscopy for treatment of acute patellar dislocation.Methods From July 2010 to June 2012,28 patients with primary acute complete dislocation of the patella had performed arthroscopic operations.Radiography was used to determine the shape and height of patella,and then the angle of femoral sulcus and the degree of joint laxity were determined before operation.All the operation were monitored under arthroscopy.At first,arthroscopy was used to explore all around inside the joints.Secondly,the free cartilage and osteochondral fragment were taken out,and the impaired surface of cartilage was repaired.Finally,lateral patellar retinaculum was released and medial retinaculum was reefed.Results All the patients were followed up,the average duration of follow-up was 1.1 years(ranged from 0.5 to 2.5 years).There was no infection,severe complication and redislocation happened.The Lysholm score was significantly improved from(78.2 ± 4.6) to(92.3 ± 2.5),(P < 0.01).Conclusion The diagnosis and treatment of acute dislocation of the patella under arthroscopy is an easily feasible operation,and its clinical outcomes are reliable.