股骨滑车发育不良对内侧髌股韧带重建术的影响
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南华大学附属长沙中心医院运动医学、关节、骨病科

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湖南省自然科学基金(编号:2020JJ8043);长沙市科技计划项目(编号:kq2004165);湖南省卫生健康委员会项目(编号:C2019133);湖南省卫生健康委员会重点项目(编号:20201902)


The Influence of trochlear dysplasia on medial patellofemoral ligament reconstruction
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Changsha Central Hospital Affiliated to University of South China, Department of Sports Medicine, Joint Surgery, Orthopedics

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    摘要:

    目的:回顾性分析内侧髌股韧带(medial patellofemoral ligment,MPFL)重建治疗伴股骨滑车发育不良的复发性髌骨脱位(Recurrent Patellar Dislocation, RPD)的中期临床结果。 方法:2013年1月至2016年12月对26例伴有股骨滑车发育不良的复发性髌骨脱位患者行关节镜辅助下MPFL双束重建术,选择性行外侧支持带松解术治疗。通过Dejour分型评价滑车发育不良分级,采用Kujala评分、Lysholm评分与Tegner评分评价膝关节功能,调查患者的满意度。 结果:22例(26膝)得到随访,失访4例,平均随访时间5.2年(3.2-6.8年)。22例患者中滑车发育不良按Dejour分型 A型10例,B型5例,C型4例,D型3例。无再脱位病例,20例患者能重返运动并对治疗效果满意。Kujala评分、Lysholm评分、Tegner评分末次随访时均较术前明显改善,差异有统计学意义(P <0. 001)。滑车轻度发育不良轻度组(Dejour A型)和重度组(Dejour B、C、D型)两组间的手术疗效差异无统计学意义(P >0. 05)。 结论:MPFL重建治疗伴股骨滑车发育不良的复发性髌骨脱位的中期疗效满意;手术疗效差异与滑车发育不良无明显相关性。

    Abstract:

    Objective: To retrospectively analyze the mid-term clinical results of medial patellofemoral ligament (MPFL) reconstruction in the treatment of recurrent patellar dislocation (RPD) with trochlear dysplasia. Methods: From January 2013 to December 2016, 26 patients with recurrent patella dislocation accompanied by trochlear dysplasia underwent arthroscopy-assisted MPFL double-bundle reconstruction. Selective patellar lateral retinaculum release was performed. Dejour classification was used to evaluate the grade of chute dysplasia. The Kujala score, Lysholm score, and Tegner score were used to evaluate knee function before and after the operations, and patient satisfaction was investigated. Results: 22 cases (26 knees) were followed up, and 4 cases were lost to follow-up. The average follow-up time was 5.2 years (3.2-6.8 years). Twenty-two patients had trochlear dysplasia according to Dejour type, 10 cases of type A, 5 cases of type B, 4 cases of type C, and 3 cases of type D. There were no cases of redislocation. 20 patients could return to exercise and were satisfied with the treatment effect. The Kujala score, Lysholm score, and Tegner score were significantly improved at the last follow-up than before surgery (P <0.001),and there were no significantly difference between the mild trochlear dysplasia group(Dejour A type)and high-grade trochlear dysplasia group(Dejour B,C,D type)(P >0.05). Conclusion: The mid-term effect of MPFL reconstruction for the treatment of recurrent patella dislocation with trochlear dysplasia is satisfactory. Surgical efficacy has no significant correlation with trochlear dysplasia.

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  • 收稿日期:2021-05-17
  • 最后修改日期:2021-10-09
  • 录用日期:2022-01-13
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