关节镜辅助下自体半腱肌腱重建内侧髌股韧带治疗髌骨脱位

目的 评价自体半腱肌腱重建内侧髌股韧带治疗髌骨脱位的临床效果.方法 2007年1月至2010年1月,用半腱肌腱重建内侧髌股韧带治疗复发性髌骨脱位患者16例.在关节镜辅助下采用自体半腱肌腱重建内侧髌股支持带,髌骨侧固定于髌骨内缘中上1/3和中点的位置,股骨侧固定于股骨内上髁和内收肌结节之间骨道内.结果 所有患者术后即行渐进性膝关节活动度训练,3个月恢复正常行走,6个月可进行体育锻炼.16例患者术后全部获得随访,随访时间7～54(26.36±20.48)个月.手术切口均一期愈合,膝关节功能恢复正常.术后Lysholm评分(93.21±4.68)分,与术前的(76.53±8.35)分比较差异有统计学意义(P＜0.05).结论 自体半腱肌腱重建内侧髌股韧带治疗髌骨脱位方法简便,能够有效恢复髌骨正常运动轨迹,是治疗复发性髌骨脱位的一种有效手术方法.

Abstract：

Objective To evaluate the clinical effects of medial patellofemoral ligament reconstruction using the semitendinosus tendon autograft for the treatment of the patellar dislocation.Methods From January 2007 to January 2010,16 cases of patellar dislocation were included in this group.Lysholm score was averaged preoperatively.Arthroscopic-assisted in the semitendinosus tendon autograft reconstruction of the medial patellofemoral ligament,the central graft were fixed on the inner edge of the patellar in the upper 1/3 and the mid-point location,the end were fixed on the channel of femoral epicondyle and adductor tubercle.Results All the patients that lined progressive knee rehabilitation after operation,returned to normal walking for 3 months,6 months could be sports.Followed up for 7-54( 26.36 ± 20.48 ) months,all of patients incision were healed as grade Ⅰ,knee function were normal.Postoperative Lysholm score (93.21 ± 4.68) scores compared with preoperative ( 76.53 ± 8.35 ) scores was significant difference (P ＜ 0.05 ).Conclusions Using the semitendinosus tendon autograft for the treatment of the patellar dislocation method is simple and can effectively restore normal patellar trajectory.At the same time,which is an effective surgical method to treat recurrentdislocation of the patellar.

Medial patellofemoral ligament reconstruction with semitendinosus tendon autograft for the treatment of patellar dislocation with arthroscopic-assisted

Objective To evaluate the clinical effects of medial patellofemoral ligament reconstruction using the semitendinosus tendon autograft for the treatment of the patellar dislocation.Methods From January 2007 to January 2010,16 cases of patellar dislocation were included in this group.Lysholm score was averaged preoperatively.Arthroscopic-assisted in the semitendinosus tendon autograft reconstruction of the medial patellofemoral ligament,the central graft were fixed on the inner edge of the patellar in the upper 1/3 and the mid-point location,the end were fixed on the channel of femoral epicondyle and adductor tubercle.Results All the patients that lined progressive knee rehabilitation after operation,returned to normal walking for 3 months,6 months could be sports.Followed up for 7-54( 26.36 ± 20.48 ) months,all of patients incision were healed as grade Ⅰ,knee function were normal.Postoperative Lysholm score (93.21 ± 4.68) scores compared with preoperative ( 76.53 ± 8.35 ) scores was significant difference (P ＜ 0.05 ).Conclusions Using the semitendinosus tendon autograft for the treatment of the patellar dislocation method is simple and can effectively restore normal patellar trajectory.At the same time,which is an effective surgical method to treat recurrentdislocation of the patellar.