关节镜下膝内侧支持带紧缩外侧支持带松解治疗髌骨脱位

目的 　探讨关节镜下膝内侧支持带紧缩外侧支持带松解术在治疗髌骨脱位中的临床疗效。 方法 自2009 年3 月～2011年7月收治25 例25膝髌骨脱位，术前未接受过外科手术治疗。术中关节镜监视下松解外侧支持带并紧缩缝合内侧支持带。术后行正规康复训练。随访18～24个月，了解膝关节脱位复发情况及患膝功能恢复情况。 结果　术后无髌骨脱位复发，手术前后Lysholm 膝关节功能综合评分分别为（59.00±13.37）分和 （92.14±5.15）分（P＜0.05）；手术后影像测量对比髌骨适合角从术前（21.10±5.61）°纠正到（-1.70±7.41）°(P＜0.05)；外侧髌股角从术前（-1.3±1.6）°纠正到（6.1±1.4）°(P＜0.05），上述3项指标手术前后比较，均有统计学差异。 结论　关节镜辅助下膝内侧支持带紧缩配合外侧支持带松解术治疗髌骨脱位，手术创伤小，疗效满意。

Arthroscopic treatment of patellar dislocation by medial retinacular reefing and lateral retinacular release

Objective　To investigate the therapeutic effects of arthroscopic medial retinacular reefing and lateral retinacular release for patellar dislocation.   Methods   From March, 2009 to July, 2011, 25 patients of patellar dislocations were treated by arthroscopic medial retinacular reefing and lateral retinacular release. All patients accepted regular rehabilitation training and were followed up for 20 months in average (18 to 24 months). The rate of recurrence，the subjective symptoms and the function of the injured leg were evaluated according to the Lysholm score. X-ray examination was taken to evaluate the patella-femur congruence and the lateral patella angle.    Results    The patellar stability was restored in all patients，and no recurrence of patellar dislocation was found within follow-up. The Lysholm scores were（59.00±13.37）and（92.14±5.15）（P＜0.05）before and after surgery respectively. X-ray examination showed that patella-femur congruence angle improved from（21.10±5.61）° to（-1.70±7.41）°(P＜0.05)， and the lateral patella angle from（-1.3±1.6）° to（6.1±1.4）° (P＜0.05) in average. The three indicators compared before and after surgery had significantly statistic differences.   Conclusion     Arthroscopic medial retinacular reefing and lateral retinacular release for patellar dislocations is effective and minimally invasive.