关节镜下重建内侧髌股韧带与射频消融治疗髌骨半脱位的对照研究

目的比较关节镜下半腱肌肌腱重建内侧髌股韧带与射频消融在治疗髌骨半脱位中的作用。方法自2008—06—2010—06收治髌骨半脱位60例，分别采用关节镜下半腱肌肌腱重建内侧髌股韧带（A组，30例）与射频消融（B组，30例）治疗，比较2组手术前、后膝关节功能Lysholm评分。结果60例均获得2年随访。A组术前Lysholm评分平均（63．2±5．3）分。末次随访时平均（87．2±5．1）分；B组术前Lysholm评分平均（65．1±6．2）分，末次随访时平均（84．2±5．4）分。A、B组末次随访时Lysholm评分均较术前明显提高；差异有统计学意义（P〈0．05）；末次随访时A组Lysholm评分高于B组。差异有统计学意义（忙3．112，P=0．003）。结论关节镜下半腱肌肌腱重建内侧髌股韧带相对于射频消融在治疗髌骨半脱位中能取得更好的治疗效果。

Comparison of arthroscopical treatment of patellar subluxation with amatomical reconstruction of medial patellofemoral ligament and radiofrequency

Objective To compare the effects of arthroseopical treatment of Patellar subluxation with amatomieally reconstruction of medial patellofemoral ligament and radiofrequeney. Methods From June 2008 to June 2010, eonseeufive 60 patients with patellar subluxation were devided into two groups. Patients of group A （30 eases）, were treated With amatomical reconstruction of medial patellofemoral ligament with grafted dual＇bundle smitendinosus while patients of group B （30 eases） were treated with arthroscopie lateral release and medial thermal retinaeulum shrinkage using a monopolar rad!ofiequeneY probe. All patients were assessed subjectively by visual analog scale and both preoperatively and postoperatively by physical examiiafition and Lyshohn knee scores. Results All the patients were followed up for 2 years. The Lysholm score Of group A was （63.2±5.3）points preoperative and （87.2±5.1）points at the last follow-up, and that of group B was （65.1±6.2）points preoperative and （84.2±5.4） points at the last follow-up. Both two groups＇ Lysholm score at the last follow-up were obviously higher than those before operation, there was significant difference （P 〈0.05）. And the Lysholm score of group A was higher than that of group B at the last follow-up, there was significant difference （t =3.112,P =0.003）. Conclusion Treatment of pateUar subIuxation by amatomieal reconstruction of medial patellofemoral ligament with grafted dual-bundle smitendinosus can achieve better overall clinical results than arthroseopie lateral release and medial thermal retinaeulum shrinkage using a monopolar radiofrequeney.