|
摘要 目的 探讨内侧髌股韧带重建联合外侧支持带松解及股骨去旋转截骨治疗复发性髌骨脱位的疗效分析。 方法 回顾性分析2017年1月至2019年1月新疆医科大学第四附属医院收治的15例股骨前倾角(femoral anteversionangle,FAA)≥30°的复发性髌骨脱位患者资料,其中男5例,女10例;年龄18~32岁,平均(20.80±4.49) 岁。结果 患者均获得随访,随访时间24~30个月,平均(28.00±1.81)个月。患者FAA术前(34.45±3.02)°,术后 (16.19±1.51)°;髌骨倾斜角术前(30.92±3.91)°,术后(7.29±3.05)°;Kujala评分术前(47.00±5.92)分,术后(95.40± 4.66)分;Lysholm评分术前(43.00±4.55)分,术后(93.80±6.03)分;手术前后比较差异均有统计学意义(P<0.05)。 结论 内侧髌股韧带重建联合外侧支持带松解及股骨远端去旋转截骨治疗FAA过大的复发性髌骨脱位,可较好地
恢复髌股关节稳定性及膝关节功能。
|
|
关键词 :
内侧髌股韧带,
重建,
外侧支持带,
松解,
股骨去旋转截骨,
髌骨外脱位
|
|
基金资助:新疆维吾尔自治区重点研发计划项目(2021B03006)
新疆维吾尔自治区自然科学基金(2022D01C170)
科技创新人才领军项目(2022TSYCLJ0007) |
通讯作者:
方锐
|
作者简介: 张文豪(1995- ),男,研究生在读,新疆医科大学第四附属医院关节外科,1358263955@qq.com |
[1]Migliorini F,Rath B,Tingart M,et al.Surgical management for recurrent patellar dislocations in skeletally immature patients[J].Eur J Orthop Surg Traumatol,2019,29(8):1815-1822.
[2]Bartsch A,Lubberts B,Mumme M,et al.Does patella alta lead to worse clinical outcome in patients who undergo isolated medial patellofemoral ligament reconstruction?A systematic review[J].Arch Orthop Trauma Surg,2018,138(11):1563-1573.
[3]Stefancin J.Firsttime traumatic patellar dislocation:A systematic review[J].Clin Orthop Relate Res,2007(455):93-101.
[4]Weber AE,Nathani A,Dines JS,et al.An algorithmic approach to the management of recurrent lateral patellar dislocation[J].J Bone Joint Surg Am,2016,98(5):417-427.
[5]Steensen RN,Bentley JC,Trinh TQ,et al.The prevalence and combined prevalences of anatomic factors associated with recurrent patellar dislocation:A magnetic resonance imaging study[J].Am J Sports Med,2015,43(4):921-927.
[6]Liu Z,Yi Q,He L,et al.Comparing nonoperative treatment,MPFL Repair,and MPFL reconstruction for patients with patellar dislocation:A systematic review and network metaanalysis[J].Orthop J Sports Med,2021,9(9):23259671211026624.
[7]Dejour H,Walch G,NoveJosserand L,et al.Factors of patellar instability:An anatomic radiographic study[J].Knee Surg Sports Traumatol Arthrosc,1994,2(1):19-26.
[8]Nelitz M,Williams RS,Lippacher S,et al.Analysis of failure and clinical outcome after unsuccessful medial patellofemoral ligament reconstruction in young patients[J].Int Orthop,2014,38(11):2265-2272.
[9]Zhang Z,Zhang H,Song G,et al.Increased femoral anteversion is associated with inferior clinical outcomes after MPFL reconstruction and combined tibial tubercle osteotomy for the treatment of recurrent patellar instability[J].Knee Surg Sports Traumatol Arthrosc,2020,28(7):2261-2269.
[10]Kaiser P,Schmoelz W,Schttle PB,et al.Isolated medial patellofemoral ligament reconstruction for patella instability is insufficient for higher degrees of internal femoral torsion[J].Knee Surg Sports Traumatol Arthrosc,2019,27(3):758-765.
[11]Noonan B,Cooper T,Chau M,et al.Rotational deformitywhen and how to address femoral anteversion and tibial torsion[J].Clin Sports Med,2022,41(1):27-46.
[12]Deng X,Li L,Li Z,et al.Clinical application of femoral derotation osteotomy combined with medial patellofemoral ligament reconstruction for patellar dislocation with excessive femoral internal torsion[J].Asian J Surg,2021,44(6):891-893.
[13]Hao K,Niu YZ,Kong L,et al.Medial patellofemoral ligament reconstruction combined with derotational distal femoral osteotomy yields better outcomes than isolated procedures in patellar dislocation with increased femoral anteversion[J].Knee Surg Sports Traumatol Arthrosc,2023,31(7):2888-2896.
[14]Erickson BJ,Nguyen J,Gasik K,et al.Isolated medial patellofemoral ligament reconstruction for patellar instability regardless of tibial tubercletrochlear groove distance and patellar height:Outcomes at 1 and 2 years[J].Am J Sports Med,2019,47(6):1331-1337.
[15]Blanke F,Watermann K,Haenle M,et al.Isolated medial patellofemoral ligament reconstruction can be an effective procedure in patellofemoral instability with risk factors[J].J Knee Surg,2020,33(10):992-997.
[16]Merchant AC,Mercer RL.Lateral release of the patella:A preliminary report[J].Clin Orthop Relat Res,1974(103):40-45.
[17]Christoforakis J,Bull AM,Strachan RK,et al.Effects of lateral retinacular release on the lateral stability of the patella[J].Knee Surg Sports Traumatol Arthrosc,2006,14(3):273-277.
[18]Wang XL,Peng C,Tu YW,et al.Effects of lateral patellar retinaculum release for recurrent patella dislocation:A prospective study[J].Int J Gen Med,2021(14):5527-5535. |
[1] |
范帅,蔡斌,贺英,姜鑫,王娟. “姆瓦”术中关节腔注射对膝关节黏连患者早期膝关节屈曲角度恢复的影响[J]. 实用骨科杂志, 2023, 29(9): 839-. |
[2] |
郭帅,唐述森. 前交叉韧带重建术股骨侧定位“理想点”等张重建的临床效果研究[J]. 实用骨科杂志, 2023, 29(8): 689-. |
[3] |
钱臣,秦万金,徐扬,朱斌杰,孔志刚,汤立平. 关节镜辅助下三束重建治疗急性肩锁关节脱位[J]. 实用骨科杂志, 2023, 29(8): 717-. |
[4] |
张文豪,热米拉·艾买提,袁智宇,牟利民,张思平,向文远,方锐. 关节镜下内侧髌股韧带重建与内侧支持带紧缩治疗青少年复发性髌骨脱位疗效研究[J]. 实用骨科杂志, 2023, 29(8): 742-. |
[5] |
姜伟琪,段英超,赵根,李涵,金文铭,李宝,吴芳芳,刘欣伟. 疫情模式下前交叉韧带重建术后的康复策略研究[J]. 实用骨科杂志, 2023, 29(5): 456-. |
[6] |
高锋,殷浩荣,陈广辉,杨海宝,钟天伟,汤奇. 关节镜下跖腱膜松解联合跟腱止点清理术治疗顽固性跟痛症[J]. 实用骨科杂志, 2023, 29(5): 465-. |
[7] |
贾熠辰,徐斌,郭瑞鹏. 内侧髌股韧带重建术中骨骺闭合与否对股骨侧定位方法选择的影响[J]. 实用骨科杂志, 2023, 29(4): 315-. |
[8] |
卓泽铭,金旭红,王和杰,邢势,钟海波. 膝关节脱位合并多发韧带损伤的临床疗效及预后影响因素[J]. 实用骨科杂志, 2023, 29(3): 255-. |
[9] |
胡建海,吴鹏,周正,蒋江云,薛超,祝闽. 单侧双通道关节镜治疗慢性足底筋膜炎的疗效分析[J]. 实用骨科杂志, 2023, 29(3): 269-. |
[10] |
王微,李红川,李剑,石立田,康汇. 关节镜下360°关节囊松解治疗黏连性肩关节囊炎[J]. 实用骨科杂志, 2023, 29(2): 102-. |
[11] |
李俊,刘俊才,李远,李凌志,何彦威,江浩,李忠. 完全经骺板重建术治疗青少年前交叉韧带损伤的疗效分析[J]. 实用骨科杂志, 2022, 28(9): 787-. |
[12] |
刘守东,谢洪彬,单森,刘南伯,王勃,刘慧莉. 移植肌腱与半月板后根吻合联合Pull-out法重建半月板后根[J]. 实用骨科杂志, 2022, 28(9): 842-. |
[13] |
金天福,李彦林. 虚拟现实平衡训练联合运动训练对前交叉韧带重建术后的影响[J]. 实用骨科杂志, 2022, 28(7): 659-663. |
[14] |
罗亮,向飞帆,梁杰,叶俊武,唐炼,顾浩,阳运康. 髌股内侧韧带重建治疗非骨性畸形复发性髌骨脱位的效果分析[J]. 实用骨科杂志, 2022, 28(7): 663-666. |
[15] |
侯费祎,张莲,李慎松,杨巧巧,杨勤旭. 复发性髌骨脱位的临床治疗分析[J]. 实用骨科杂志, 2022, 28(7): 648-652. |
|
|
|