三联疗法治疗成人髌骨习惯性脱位的疗效分析
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中国医科大学附属一院

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The Curative Effect Analysis For The Treatment of Adult Patella Habitual Dislocation Using Triple Therapy
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The First Afflicated Hospital of China Medical University

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    摘要:

    目的:探讨以三联疗法(膝关节外侧支持带松解、内侧髌股韧带双束解剖重建、胫骨结节Elmslie-Trillat截骨)治疗成人髌骨习惯性脱位的疗效。方法 回顾性分析2011年6月至2017年12月以四联疗法手术治疗习惯性髌骨脱位患者的临床资料,共10例,其中男2例,女8例;平均年龄22.5岁(19-46岁);既往外伤史4例,无明显诱因6例;左膝3例,右膝7例,无双侧患者。记录手术前后患者膝关节活动度、Lysholm评分、Kujala评分、Insall评定以及髌骨恐惧试验、髌骨研磨试验结果,以便对手术效果进行评价。结果 所有患者均获得随访,时间12-60个月,平均24.8个月。术后所有患者切口愈合良好,无感染、再脱位、膝关节僵硬活动受限等严重并发症。末次随访时患者膝关节活动度(131.0±10.22)°,与术前的(106.5±14.73)°相比差异具有统计学意义(P<0.001);Lysholm评分(87.4±2.37)分,高于术前的(43.2±3.19)分;Kujala评分(88.3±4.76)分,高于术前的(43.9±2.60)分;Insall评定法评定优7例,良3例。结论 以三联疗法治疗成人髌骨习惯性脱位疗效确切,有助于提高髌骨稳定性和改善膝关节功能。

    Abstract:

    Objective To explore the curative effect for the treatment of adult patellar habitual dislocation using quadruple therapy(knee joint lateral retinaculum release,anatomical double-bundle medial patellofemoral ligament reconstruction,tibial tubercle Elmslie-Trillat osteatomy).Methods The clinical data of the patients with habitual patella dislocation were analyzed retrospectively from June 2011 to December 2016, with a total of 10 cases, including 2 males and 8 females; average age: 22.5 years old (19-46 years old);there were 6 cases with no obvious inducement and 4 cases with trauma history; 3 cases of left knee, 7 cases of right knee, no bilateral patients. The knee joint activity, Lysholm scores, Kujala scores, Insall evaluation method , patellar apprehension test and patella abrasion test were recorded before and after surgery to evaluate the surgical effect. Results All patients were followed up for 12-60 months and averaged 24.8 months. All patients had good incision healing, no infection, re-dislocation, knee stiffness and other serious complications postoperatively. The knee joint activity at the last follow-up was 131.0°+10.22°,the differences was statistically significant (P < 0.001) compared with preoperative 106.5°- 14.73°; Lysholm scores at the last follow-up was 87.4+2.37, which was much higher than the preoperative 43.2±3.19;87.4+2.37of Lysholm scores at the last follow-up was also much higher than the preoperative 43.9+2.60.Acorrding to Insall Evaluation Method ,there were 7 cases excellence, 3 cases good in the patients after surgery.Conclusion It is helpful to improve the stability of patella and improve the function of knee joint for the treatment of adult patella habitual dislocation using triple therapy.

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  • 收稿日期:2019-02-15
  • 最后修改日期:2019-03-05
  • 录用日期:2019-03-12
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