复发性髌骨脱位的治疗现状

复发性髌骨脱位的主要表现是膝关节周围广泛的疼痛、肿胀和反复的髌骨向外侧脱位。其发病的主因是患者存在膝关节解剖结构异常,如Q角增加、髌骨高位、股骨外髁发育不良、髌骨形态异常、股直肌内侧头萎缩或股直肌外侧头肥大等。本文综述45篇文献,总结了其手术治疗方法。目前复发性髌骨脱位的治疗方法有很多种,大致包括五类:外侧松解、伸膝装置近端重排、伸膝装置远端重排、伸膝装置远、近端联合手术及髌骨切除和股四头肌成形修补术。其中远端重排手术效果最佳,目前尚无一种方法能成功地用于矫正复发性髌骨脱位。

Current treatment of recurrent patellar dislocation

Patients who suffer from recurrent patellar dislocation frequently complain of diffuse pain around the knee, swelling and dislocation or subluxation of the patella. Anatomical abnormalities should be responsible for the condition, such as increased Q angle, a high-riding patella, dysplasia of the femoral condyles, abnormal shape of the patella, atrophy of the vastus medialis and hypertrophy of the vastus lateralis. We reviewed 45 reports about the treatment of recurrent dislocation of the patella. The current more than 100 methods can be classified as: lateral release, proximal realignment, distal realignment, proximal and distal realignment, patella-tomy and plastic repair of quadriceps. Of all these methods, proximal realignment is the best, but there has been no method which can successfully and generally repair the recurrent patellar dislocation.