关节镜辅助下内侧髌股韧带重建治疗急性髌骨脱位的中期随访

目的探讨关节镜辅助下内侧髌股韧带(medial patellofemoral ligament, MPFL)重建治疗急性髌骨脱位(acute patellar dislocation, APD)的中期临床疗效。方法 2016年3月至2018年3月,我科采用关节镜辅助下MPFL重建手术治疗19例APD病人,其中男7例,女12例;年龄为(21.5±6.3)岁。所有病人于术中进行关节镜检查,评估髌骨轨迹,然后进行MPFL重建。术后6个月随访复查X线片及膝关节CT,测量膝关节Q角,采用Lysholm评分评价病人术后膝关节功能情况。结果术后所有病人均获随访,随访时间为(11.7±5.3)个月。术后无髌骨再脱位发生,恐惧试验阴性,关节功能恢复良好。术后6个月,19例病人的髌骨Q角为15.37°±1.46°,较术前的17.63°±1.83°显著减小,差异具有统计学意义(t=5.938,P<0.001);术后6个月19例病人的膝关节Lysholm评分为(90.47±2.83)分,较术前的(67.63±7.14)分明显提高,差异具有统计学意义(t=-16.052,P<0.001)。结论关节镜辅助下MPFL重建治疗APD的中期临床效果良好。

Mid-term follow-up of arthroscopic reconstruction of medial patellofemoral ligament in the treatment of acute dislocation of the patella

Objective To explore the mid-term clinical effect of arthroscopic assisted reconstruction of medial patellofemoral ligament(MPFL) in the treatment of acute patellar dislocation(APD).Methods From March 2016 to March 2018,19 patients with APD were treated by arthroscopic assisted MPFL reconstruction,including 7 males and 12 females,aged(21.5±6.3) years.The arthroscopic examination was undertaken before the repairing to observe the patellar track,as well as MPFL reconstruction.Six months after operation,X-ray film and CT were followed up for re-examination,Q-angle of knee joint was measured,and Lysholm score was used to evaluate the function of knee joint.Results All patients were followed-up for(11.7±5.3) months.There was no re-dislocation of patella after operation,the fear test was negative,and the joint function recovered well.The Q angle was 15.37°±1.46° at 6 th month postoperatively,which was significantly reduced as compared with that before operation(17.63°±1.83°);the Lysholm score was 90.47±2.83 at 6 th month postoperatively,which was significantly higher than that before operation(67.63±7.14);both the differences were statistically significant(t=5.938,P<0.001;t=-16.052,P<0.001).Conclusion The mid-term clinical effect of arthroscopic assisted MPFL reconstruction in the treatment of APD is good.