髌外侧支持带松解加减压：不破坏髌软骨面的修复治疗

背景：髌骨外侧高压综合征常合并有外侧支持带的紧张和影像学上的髌骨倾斜,CT扫描显示,外侧支持带松解能有效地纠正髌骨外侧倾斜。 目的：分析关节镜下髌外侧支持带松解联合关节外髌骨钻孔减压治疗髌骨外侧高压综合征的疗效。 方法：对32例髌骨外侧高压综合征患者行关节镜下髌外侧支持带松解加关节外髌骨钻孔减压,采用Lysholm 膝关节功能评分评价治疗效果。 结果与结论：患者治疗后随访均超过12个月。治疗后1个月所有患者膝关节疼痛明显减轻或消失,1 年后26例疼痛基本消失。Lysholm 评分,优20例,良6例,可4例,差2例,优良率83.6%,患者主观满意率为92.8%。说明关节镜下松解髌外侧支持带加关节外髌骨钻孔减压治疗髌骨外侧高压综合征具有创伤小、康复快等优点,在不破坏髌骨软骨面的情况下进行髌骨减压,对髌股关节疼痛伴有髌骨向外侧倾斜且关节软骨退变较轻的病例,疗效良好。

Lateral patellar retinacular release combined with decomposition: Repair without damage to the patellar cartilage surface

BACKGROUND: Excessive lateral pressure syndrome is often associated with lateral retinacular tension and radiographic patellar tilt. CT scan displayed that lateral retinacular release can effectively correct patellar tilt. OBJECTIVE: To study the effect of arthroscopic lateral retinacular release combined with intraosseous drilling and decomposition in the treatment of excessive lateral pressure syndrome. METHODS: Thirty-two patients with excessive lateral pressure syndrome were treated by arthroscopic lateral release combined with intraosseous drilling and decomposition. The Lysholm scoring system was used to evaluate the treatment effect. RESULTS AND CONCLUSION:The mean duration of follow-up was 12 months. After 1 month, pain of all patients was released or disappeared; after 1 year, pain of 26 cases disappeared basically. Lysholm scoring system assessment showed 20 cases were rated as excellent, six cases were as good, four cases were as fair and two cases were as poor. The excellent and good rate was 83.6%. The patients’ subjective satisfaction rate was 92.8%. The results indicate that arthroscopic lateral release combined with intraosseous drilling and decomposition is a good method to treat excessive lateral pressure syndromewere. It has the advantages of less trauma and rapid recovery. Patellar decomposition has a good effect in the treatment of patellofemoral pain associated with patellar tilt outward and lightens articular cartilage degeneration without damage to patellar cartilage surface.