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-  2015 

骨锚技术重建伸膝装置治疗青少年复发性髌骨半脱位的疗效分析

DOI: doi:10.7507/1002-1892.20150262

Keywords: 复发性髌骨半脱位, 伸膝装置, 骨锚技术, 青少年

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Abstract:

目的探讨骨锚技术重建伸膝装置治疗青少年复发性髌骨半脱位的疗效。 方法2010年1月-2013年12月,采用骨锚技术重建伸膝装置治疗20例青少年复发性髌骨半脱位。男11例,女9例;年龄12~17岁,平均15.3岁。左膝12例,右膝8例。病程5~10年,平均7年。患者均有不同程度膝关节疼痛。均为外侧半脱位,术前Lysholm评分为(71.4±4.7)分。MRI检查排除半月板、韧带损伤。CT检查示髌股关节胫骨结节-股骨滑车间距为15~20 mm,平均17 mm。X线片检查示下肢力线未见明显内、外翻畸形,骨性结构正常。 结果术后切口均Ⅰ期愈合。患者均获随访,随访时间12~24个月,平均13个月。术后发生膝关节疼痛2例,经对症处理后症状缓解。术后1年膝关节轴位X线片示髌骨位置正常,髌股关节解剖关系恢复正常。随访期间无骨锚脱落、断裂,无明显假关节形成、内固定失败发生;无髌骨半脱位复发。术后1年Lysholm评分为(94.2±3.4)分,较术前显?著改善(t=22.705,P=0.000);根据Insall标准评定疗效:优9例,良9例,可2例,优良率90%。 结论采用骨锚技术重建伸膝装置治疗青少年复发性髌骨半脱位操作简便,并发症少,近期疗效满意,远期疗效有待进一步随访

References

[1]  5. 张金平, 李彦林, 金耀峰, 等. 胫骨结节抬高内移术治疗髌骨半脱位的临床分析. 昆明医学院学报, 2010, 31(9):64-66.
[2]  6. Becher C, Kley K, Lobenhoffer P, et al. Dynamic versus static reconstruction of the medial patellofemoral ligament for recurrent lateral patellar dislocation. Knee Surg Sports Traumatol Arthrosc, 2014, 22(10):2452-2457.
[3]  7. 卢世壁, 主译. 坎贝尔骨科手术学. 9版. 山东:科学技术出版社, 2004:1317-1318.
[4]  8. Biyani R, Elias JJ, Saranathan A, et al. Anatomical factors influencing patellar tracking in the unstable patellofemoral joint. Knee Surg Sports Traumatol Arthrosc, 2014, 22(10):2334-2341.
[5]  3. Kita K, Tanaka Y, Toritsuka Y, et al. Patellofemoral chondral status after medial patellofemoral ligament reconstruction using secondlook arthroscopy in patients with recurrent patellar dislocation. J Orthop Sci, 2014, 19(6):925-932.
[6]  4. 赵波, 冉霞, 张铭华, 等. 关节镜下髌骨内侧支持带紧缩术治疗青少年急性髌骨脱位. 中国修复重建外科杂志, 2013, 27(12):1437-1441.
[7]  9. Niimoto T, Deie M, Adachi N, et al. Quantitative stress radiography of the patella and evaluation of patellar laxity before and after lateral release for recurrent dislocation patella. Knee Surg Sports Traumatol Arthrosc, 2014, 22(10):2408-2413.
[8]  10. Leferbvre R, Leroux A, Poumarat G, et al. Vastus medialis: anatomical and functional considerations and implications based upon human and cadaveric studies. J Manipulative Physiol Ther, 2006, 29(2):139-144.
[9]  18. Wang S, Ji G, Yang X, et al. Femoral trochlear groove development after patellar subluxation and early reduction in growing rabbits. Knee Surg Sports Traumatol Arthrosc, 2014.[Epub ahead of print].
[10]  1. Balcarek P, Oberthür S, Hopfensitz S, et al. Which patellae are likely to redislocate? Knee Surg Sports Traumatol Arthrosc, 2014, 22(10): 2308-2314.
[11]  2. Rhee SJ, Pavlou G, Oakley J, et al. Modern management of patellar instability. Int Orthop, 2012, 36(12):2447-2456.
[12]  11. Lin YF, Lin JJ, Jan MH, et al. Role of the vastus medialis obliquus in repositioning the patella:a dynamic computed tomagraphy study. Am J Sports Med, 2008, 36(4):741-746.
[13]  12. Kim MK, Na SI, Lee JM, et al. Comparison of bioabsorbable suture anchor fixation on the tibial side for anterior cruciate ligament reconstruction using free soft tissue graft:experimental laboratory study on porcine bone. Yonsei Med J, 2014, 55(3):760-765.
[14]  13. Petri M, Dratzidis A, Brand S, et al. Suture anchor repair yields better biomechanical properties than transosseous sutures in ruptured quadriceps tendons. Knee Surg Sports Traumatol Arthrosc, 2015, 23(4):1039-1045.
[15]  14. 鱼红进, 刘兴国, 宋明辉, 等. 髌骨习惯性脱位的手术治疗. 中国伤残医学, 2013, 21(7):10-11.
[16]  15. Balcarek P, Oberthür S, Frosch S, et al. Vastus medialis obliquus muscle morphology in primary and recurrent lateral patellar instability. Biomed Res Int, 2014, 2014:326586.
[17]  16. 胥少汀, 葛宝丰, 徐印坎. 实用骨科学. 4版. 北京:人民军医出版社, 2012:2258.
[18]  17. Lee CH, Wu CC, Pan RY, et al. Medial retinacular flap advancement and arthroscopic lateral release for symptomatic chronic patellar lateral subluxation with tilting. Knee Surg Sports Traumatol Arthrosc, 2014, 22(10):2499-2504.

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