"三联术式"治疗习惯性髌骨脱位

目的:使用"三联术式"治疗习惯性髌骨脱位,观察胫骨结节内移、上移+外侧支持带松解+MPFL重建,三联术式治疗习惯性髌骨脱位的疗效.方法:我科自2015年-2018年对32例习惯性髌骨脱位患者行胫骨结节内移、上移+外侧支持带松解+MPFL重建三联术式治疗.其中单膝20例,双膝6例,男10人,女22人,年龄17-52岁.手术前后测量胫骨结节-股骨滑车沟距离(TT-TG),测量caton指数,其中30例获随访,时间24-36个月,使用Lysholm评分,术前(48.5±10.78)分,差异有统计学意义(P<0.05).术后24个月为(85.13±6.21)分.Kujala评分,术前(42.31±12.57)分,术后24个月(83.51±6.37)分,差异有统计学意义(P<0.05).患膝症状较术前明显好转,术前TT-TG=(32.51±2.21)mm,术后TT-TG=(10.02±2.13)mm,差异有统计学意义(P<0.05).结论:外侧支持带松解+胫骨结节内移、上移+内侧髌股韧带重建三联术式能够有效恢复髌股关系,纠正习惯性髌骨脱位,改善膝关节症状,提高膝关节功能,也有助于膝关节软骨再生.

To Tread Habitual Patellar Dislocation by Triple Union Operations

Objective:To observe the effect of Tibial tubercle internal displacement,upward displacement+lateral support band re-lease+MPFL reconstruction(triple operation)in the treatment of habitual patellar dislocation.Methods:From 2015 to 2018,32 patients with habitual patellar dislocation were treated with tibial tubercle internal displacement,upward displacement+lateral support band re-lease+MPFL reconstruction in our department.There were 20 cases with one knee and 6 cases with both knees,including 10 males and 22 females(aged 17 to 52).The caton index(tt-tg)was measured before and after surgery,and 30 cases were followed up for 24-36 months.Lysholm score(48.5±10.78 points before surgery)was used.Results:The difference was statistically significant(p<0.05).24 months after surgery,the score was 85.13±6.21.Kujala score was 42.31±12.57 before surgery and 83.51±6.3724 months after surgery,and the difference was statistically significant(p<0.05).The symptoms of the knee were significantly improved compared with those before surgery,with tt-tg=32.51±2.21mm before surgery and tt-tg=10.02±2.13mm after surgery,and the difference was statistically significant(p<0.05).Conclusion:The triple operation of lateral retinacular release+tibial tuberosity internal displace-ment+medial patellofemoral ligament reconstruction can effectively restore patellofemoral relationship,correct habitual patellofemoral dislocation,improve knee joint symptoms,improve knee joint function,and contribute to knee cartilage regeneration.