单隧道异体肌腱重建内侧髌股韧带治疗髌骨不稳——12例临床报告

目的探讨单隧道同种异体肌腱移植重建内侧髌股韧带（MPFL）治疗髌骨不稳的手术技巧及临床疗效。方法回顾性分析2010年6月至2012年1月广州军区广州总医院采用膝关节镜监视下单隧道异体肌腱移植重建MPFL的12例（15膝）髌骨不稳患者的临床资料,评估患者术前和末次随访时Kujala评分、Lysholm评分等指标。结果术后随访时间3～21个月（平均12.3个月）。患者术前和末次随访时Kujala评分为（71.5±5.1）分和（93.2±2.4）分,两者比较,差异有统计学意义（t=-12.659,P=0.004）;Lysholm评分为（70.2±6.0）分和（94.4±1.8）分,两者比较,差异有统计学意义（t=-12.286,P=0.013）。结论膝关节镜监视下单隧道同种异体肌腱移植重建MPFL是一种治疗髌骨不稳的有效方法,对维持髌骨稳定有重要作用,但远期效果需进一步观察。

Medial patellofemoral ligament reconstruction using allograft tendon in single tunnel for patellar instability: a preliminary report of twelve cases

objective To investigate the clinical procedure and effectiveness of medial patellofemoral ligament (MPFL) reconstruction using allograft tendon in single tunnel for patellar instability. Methods From June 2010 to January 2012, 12 patients (15 knees) with patellar instability were treated by arthroscopic medial MPFL reconstruction using allograft tendon in single tunnel at Guangzhou General Hospital of Guangzhou Military Command. Kujala patellofemoral scores and Lysholm scores were assessed at the preoperation and the last follow-up. Results All patients were followed up for an average of 12.3 months (from 3 to 21 months). The Kujala score was improved from 71.5 ± 5.1 preoperatively to 93.2 ± 2.4 postoperatively, and Lysholm score was improved from 70.2 ± 6.0 to 94.4 ± 1.8, both showing significant differences(t = -12.659, -12.286; P = 0.004, 0.013). Conclusion Medial patellofemoral ligament reconstruction using allograft tendon in single tunnel can effectively treat patellar instability. This procedure may have an important impact on knee joint function, but the long-term results needs a further observation.