改良Hauser小切口手术治疗髌骨不稳定18例

目的 探讨和总结改良Hauser小切口(MHSI)手术治疗髌骨不稳定(LPI)的手术经验和治疗效果。方法 从1998年10月至2000年4月间，共有18例患者(22膝)接受MHSI治疗。切口位于髌腱前稍偏外，长约4～5cm；上、下潜行牵拉切口松解外侧关节囊，胫骨结节移位。结果 18例患者全部经过随访，平均随访时间为28个月(24～40个月)。无一例复发，采用Lysholm评分法及VAS评分法评定术后膝功能，全组病例平均分值分别为91分(67～98分)和86分(66～96分)。单纯不稳定组(13膝)与合并关节退变组(9膝)术前在平均年龄和平均病程上存在统计学差异，术后评分差异无显著意义。结论MHSI对LPI有可靠疗效，手术简便、微创，可降低OA发病率，允许早期康复，是一种较好的治疗方法。

Treatment of lateral patellar instability (LPI) with modified Hauser small incision (M. H. S. I) ( A report of 18 cases)

Objective To study and review the outcomes of the treatment of lateral patellar instability with mod- ified Hauser small incision (MHSI). Methods Eighteen cases(22 knees) have been treated with MHSI from oct. 1998 to April 2000. The incision was made a little laterally to the lateral margin of patella tendon with the length 4-5cm. The release of the lateral capsule and the shift of the tibial tubercle were made through a small incision. Results All cases were followed up from 24 to 40 months. The mean follow - up was 28 months. No one got recurrent. The functions of the knees were evaluated by using Lysholm and VAS score system. The average score was 91 (67-98) and 86(66-96). Significant difference could be found in the mean age and mean the course between isolated unstable patellae (13 keens) and that with degenerative unstable patellae (9 knees) before surgery: but no significant difference after surgery. Conclu- sion MHSI is a reliable and useful way to treat the LPI. The early mobilization and exercise allowed to decrease the mor- bidity of OA knee.