关节镜辅助下LARS人工韧带重建内侧髌股韧带治疗复发性髌骨脱位

目的探讨关节镜辅助下韧带先进加强系统(ligament advanced reinforcement system,LARS)人工韧带重建内侧髌股韧带(medial patellofemoral ligament,MPFL)治疗复发性髌骨脱位(recurrent dislocation ofpatella,RDP)的临床疗效。方法我院自2007年3月～2008年7月收治了6例RDP(1例为双膝)的患者,术前行X片、CT、MRI了解髌股关节及MPFL情况,术中先用关节镜观察髌股关节的对合关系、运动轨迹及关节软骨情况;用LARS人工韧带重建MPFL;重建后关节镜检查髌股关节对合关系和运动轨迹恢复情况。术后逐步进行膝关节功能锻炼,并用Insall评定标准进行术后评分。结果随访6～24个月,平均13个月,无伤口感染、移植物排斥反应和断裂。按Insall评定标准,优5例,良1例。X片示髌骨复位良好,髌骨无复发性脱位或半脱位。结论关节镜辅助下LARS人工韧带重建MPFL能有效治疗RDP。

Arthroscopic reconstruction of medial patellofemoral ligament with LARS artificial ligament for the treatment of recurrent dislocation of the patella

Objective To investigate the clinic effect of the arthroscopic reconstruction of medial patellofemoral ligament（MPFL） with LARS artificial ligament in the treatment of recurrent dislocation of patella（RDP）.Methods Six cases of RDP were treated by arthroscopic reconstruction of MPFL with LARS artificial ligament from Mar.2007 to Jul.2008.The condition of patellofemoral joint and MPFL were detected with X-ray,CT and MRI preoperatively.The arthroscopic examination was undertaken before the reconstruction to observe the patellofemoral congruence and the patellar track,as well as articular cartilage.The MPFL was reconstructed with LARS artificial ligament.Then arthroscopic examination was taken again to measure the patellofemoral congruence and patellar track after the reconstruction.Functional training in knee joint was applied and subjective symptoms were scored postoperatively.Results No infection,graft rejection and rupture were observed in all cases.Patients were followed up for 6-24 months（ranging 13 months）.All knees＇ function were evaluated with Install＇s standard postoperatively,showing excellent in 5 cases,good in 1 case.X-ray measurement indicated excellent patella reduction without recurrence of dislocation or subluxaion.Conclusion It is effective to treat RDP by way of reconstruction of MPFL with LARS artificial ligament under guide of arthroscopy.