复发性髌骨脱位的关节镜诊断与治疗

目的探讨复发性髌骨脱位的关节镜诊断和治疗。方法 2010年2月至2014年5月我院收治并采用关节镜治疗复发性髌骨脱位患者35例,左膝14例,右膝21例。术前行X线、CT、MR检查。采用Lysholm评分评价术前与术后膝关节功能。根据术前评估及术中关节镜检查情况采用不同术式：4例行关节镜下清理术加髌内侧支持带射频紧缩;9例行关节镜下清理加髌内侧支持带紧缩缝合术;22例行关节镜下清理加髌内侧支持带紧缩缝合及髌外侧支持带松解术。结果所有患者均获得随访,时间25-42个月,平均（28.2±4.3）个月。Lysholm评分,术后2年（94.2±3.6）分高于术前的（57.4±3.8）分,差异有统计学意义（P﹤0.05）,采用Insa评分标准,优18膝,良15膝,可2膝,差0膝,优良率94.3﹪。结论采用关节镜技术诊断和治疗复发性髌骨脱位具有创伤小、恢复快,操作方法简便,效果好等优点。

Arthroscopic diagnosis and treatment of recurrent patella dislocation

Objective： To evaluate the arthroscopic diagnosis and treatment of recurrent patella dislocation. Methods：From February 2010 to July 2014,35 patients with recurrent patella dislocation were diagnosed and treated by arthroscopic.Before operation,radiograph was used to check. Lysholm scoring system was used to assess keen function before and after operation. Different surgical procedures were selected according to the type and the arthroscopic examinations. Results：Thirty-five cases were followed in an average of 28. 2 months（ ranged from 25 months to 42 months）. Lysholm score was significantly improve from preoperative 57. 4 ± 3. 8 to postoperative 94. 2 ± 3. 6（ P ﹤ 0. 05）. According to Insall scale,the results were excellent in 18 knees,good in 15 knees,and fair in 2 knees,bad 0 in 3 years after operation with an excellent and good rate of 94. 3 ﹪. Conclusion： Arthroscopic diagnosis and treatment of recurrent patella dislocation should be a preferred method,due to its minimal invasion,possibility of early mobilization,simplicity and effectiveness,which should be used in clinical practice.