关节镜手术治疗急性髌骨脱位的临床疗效分析

目的：探讨关节镜在急性髌骨脱位中的应用,评价关节镜下治疗方法的临床疗效。方法：2002年5月至2009年3月,共收治急性髌骨脱位36例,男6例,女30例;年龄12～30岁,平均20.5岁;左侧15例,右侧21例,均为单侧受累。术前对所有患者行放射学检查观察股骨髁发育、下肢对线状况,测量Q角、股骨滑车角。全部病例在关节镜下手术,取出游离骨软骨碎片,松解外侧支持带以及皮下紧缩缝合内侧支持带。结果：随访13～60个月,平均42个月,均未发生感染等并发症,全部病例膝关节活动恢复正常,无疼痛、绞锁等症状。Lysholm评分由术前平均（28.9±2.5）分增加到术后平均（95.1±8.4）分,未发生再脱位。结论：急性髌骨脱位是一个潜在的破坏性损伤,关节镜手术治疗在急性髌骨脱位中实用,创伤小,恢复快,有效且可靠。

Arthroscopic treatment of acute patellar dislocation

Objective: To investigate therapeutic effects of arthroscopic treatment for acute patellar dislocation. Methods: From May 2002 to March 2009,36 patients with acute patellar dislocation were treated with arthroscopy,including taking out of the free cartilage chips,relaxing lateral retinaculum and tight suturing medial retinaculum. Among the patients,6 patients were males and 30 patients were females,ranging in age from 12 to 30 years(averaged,20.5 years). Fifteen patients had the dislocations on the left an 21 patients had the dislocations on the right. The development of condyles of femur and Q trianglel were detected by preoperative radiology. The Lysholm criteria system was used to evaluate the clinical effects. Results: All the patients were followed up,and the duration ranged from 13 to 60 months(averaged,42 months). All the patients had no complications such as infection,and the knee range of motion recovered to normal without pain. The Lysholm score improved from preoperative(28.9±2.5) to postoperative(95.1±8.4). All the patients had no redislocation. Conclusion: Acute dislocation of the patella is an potential devastating injury. The arthroscopic treatment for acute patellar dislocation has advantages such as less trauma,faster recovery and more reliable.