自体肌腱移植双束解剖重建内侧髌股韧带治疗髌骨脱位

背景：对于髌骨不稳的治疗,临床上一般分为保守和手术治疗,其中手术治疗方法众多,每种方法各有侧重,对于使用何种方法治疗髌骨不稳,目前仍没有形成统一的共识。 目的：探讨应用自体移植肌腱双束解剖重建内侧髌股韧带治疗髌骨脱位。 方法：选择安徽医科大学第一附属医院骨科行膝关节镜辅助下内侧髌股韧带重建髌骨脱位患者46例,所有患者均采用自体移植肌腱双束解剖重建。 结果与结论：重建后随访2~16个月,观察患者关节稳定性及灵活度。46例患者随访期间未见严重并发症,患膝轻度伸直受限1例,重建后均未见髌骨复发脱位。重建后随访Lysholm膝关节评分和Kujala评分均高于重建前(P < 0.01)。结果证实,采用膝关节镜辅助下自体移植肌腱双束解剖重建内侧髌股韧带治疗髌骨脱位效果较好。 

Anatomical double bundle reconstruction of medial patellofemoral ligament for patellar dislocation through autologous tendon graft treatment

BACKGROUND: Clinically for the treatment of patellar instability, can be divided into conservative method and surgical method. There are so many surgical treatment, each one has focus and inadequate. However, there is still no unified consensus on which method should be used for the treatment of patellar instability. OBJECTIVE: To investigate the application of anatomical double bundle reconstruction of medial patellofemoral ligament for the treatment of patellar dislocation through autologous tendon graft. METHODS: A total of 46 patients that had been treated with arthroscopic double bundle medial patellofemoral ligament reconstruction by using the semitendinosus tendon for patellar dislocation in the Department of Orthopedics, First Affiliated Hospital of Anhui Medical University. RESULTS AND CONCLUSION: All cases were followed-up for 2-16 months and the patient’s range of motion and stability were assessed. During follow-up, no patients had serious complications, and all patients gained normal knee activity, except 1 case straight restricted. No patellar dislocation occurred postoperatively. The mean Lysholm score and the Kujala knee function score postoperative were improved compared with those preoperative (P < 0.01). This study concludes that medial patellofemoral ligament with anatomical double bundle reconstruction using the semitendinosus tendon for the treatment of patellar dislocation is an effective method.