关节镜辅助下可吸收软骨钉固定急性髌骨脱位合并膝关节骨软骨骨折的临床疗效观察

摘要] 目的 探讨关节镜辅助下可吸收软骨钉固定急性髌骨脱位合并膝关节骨软骨骨折的临床疗效。方法 回顾性分析西宁市第一人民医院2016年3月至2020年1月通过关节镜辅助下可吸收软骨钉固定治疗的33例急性髌骨脱位合并膝关节骨软骨骨折患者，随访7 ～ 28个月，平均（15.15±5.54）个月，术前及术后6个月时完善X线、CT评价骨折复位愈合情况，并用Lsyholm评分、HSS评分评价膝关节功能。结果 术后33例骨折均获得满意的复位，术后6个月复查时均达到骨性愈合，膝关节屈伸活动良好，未发生感染、骨块移位、关节僵硬等并发症，Lsyholm评分从术前（19.33±6.86）分提高到术后6个月（89.72±5.11）分，差异有统计学意义（P<0.01）；HSS评分从术前（38.63±7.40）分提高到术后6个月（92.15±4.42）分，差异有统计学意义（P<0.01）。结论 关节镜辅助下可吸收软骨钉固定急性髌骨脱位合并膝关节骨软骨骨折，可微创、准确、安全地恢复关节面完整性，无需二次手术取出内植物，治疗效果确切，是髌骨脱位合并骨软骨骨折的良好的治疗方式。

Clinical effect of knee osteochondral fracture of acute patella dislocation using resorbable screw fixation assisted by arthroscopy

Abstract]Objective To investigate the clinical effect of resorbable screw fixation in the treatment of knee osteochondral fracture of acute patella dislocation assisted by arthroscopy. Methods A total of 33 cases with patella osteochondral fracture caused by acute patellar dislocation treated by resorbable screw fixation assisted by arthroscopy from March 2016 to January 2020 in Xining First People''s Hospital were retrospectively analyzed, with an average follow-up of (15.15±5.54) months (7-28 months). To evaluate fracture reduction and healing, X-ray and CT were performed preoperatively and at 6 months postoperatively. The knee function was evaluated by Lsyholm score and HSS score. Results All 33 cases of osteochondral fracture were reduced satisfactorily,and bone healing was achieved half a year after surgery with normal knee flexion and extension. No complications, such as infection, displacement and joint stiffness occurred. Lsyholm score increased from (19.33±6.86) scores at preoperatively to (89.72±5.11) scores at 6 months postoperatively,and the differences were statistically significant(P<0.01). The HSS score increased from (38.63±7.40) scores at preoperatively to (92.15±4.42) scores at 6 months postoperatively,and the differences were statistically significant(P<0.01). Conclusion Resorbable screw fixation assisted by arthroscopy could accurately and safely restore articular surface integrity in the treatment of knee osteochondral fracture of acute patella dislocation, and second surgery will not be needed to remove the screws. The curative effect is definite, and thus could be considered to be a good treatment method for patellar osteochondral fracture.