关节镜辅助下同种异体腱重建内侧髌股韧带治疗骨骺未闭的青少年髌股关节不稳定

目的 探讨关节镜辅助下同种异体腱重建内侧髌股韧带治疗骨骺未闭的青少年髌股关节不稳定的临床疗效。方法 2008年6月至2010年1月，新疆医科大学第一附属医院骨科中心共收治骨骺未闭的青少年髌股关节不稳定38例61膝。所有患者均在关节镜辅助下行同种异体腱重建内侧髌股韧带手术。术前术后对患者行ICDK评分及Lysholm评分，并拍摄髌骨轴位片，测量适合角、外侧髌股角、髌骨倾斜角、髌骨移位距离、髌骨外移距离及Q角。结果 术后所有患者切口均一期愈合，无感染，无骨骺损伤。成功随访共33例52膝，随方时间8～26个月，平均14个月。术后患者髌骨恐惧试验均为阴性，膝关节功能恢复正常，随访期间无一例复发脱位。末次随访时拍摄髌骨轴位片，测量适合角、外侧髌股角、髌骨倾斜角、髌骨移位距离、髌骨外移距离分别为：（-4.4±3.1）°、(10.2±2.4)°、(4.7±1.9)°，（2.2±1.3）mm、（3.7±1.8）mm，测量Q角为(8.9±4.7)°，较术前差异有统计学意义(P＜0.05)。末次随访时ICDK评分及Lysholm评分分别为：(95.1 ±5.1)和(91.1±5.3)，较术前相比差异有统计学意义(P＜0.05)。结论 关节镜辅助下同种异体腱重建内侧髌股韧带治疗骨骺未闭的青少年髌股关节不稳定创伤小，方法 可靠。

Treatment of instability of patellofemoral joint through athroscopic repair of medial patellofemoral ligament tor adolescents with epiphyseal non-closure by allogenic tendon

Objective To explore the efficacy of arthroscopic repair of medial patellofemoral ligament (MPFL) for adolescents with epiphyseal non-closure by allogenic tendon in the treatment of instable patellofemoral joint. Methods There were a total of 38 cases including 61 knees with patellofemoral instability from June 2008 to January 2010 at our department. They were diagnosed according to the history of illness, apprehension test and tangential position radiograph in patellofemoral joint. Results A total of 33 patients with 52 knees were followed up for an average of 12 months (range:8 -19). All apprehension tests were negative. No recurrent displacement was found. The pre-operative Lysholm score of 75.5 ± 4.7 increased to 91.1 ±5.7. There was significant difference. Conclusion Arthroscope-assisted allograft reconstruction of medial patellofemoral ligament tendon is both mini-invasive and reliable for the treatment of epiphyseal nonclosure adolescents with traumatic patellofemoral instability.