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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:

第25卷

期数:

2017年08期

页码:

35-38

栏目:

临床研究

出版日期:

2017-08-03

文章信息/Info

Title:

Comparison of Autogenous Patellar Tendon Graft in Single Tunnel and Double Patellar Anchor for Medial Patellofemoral Ligament Reconstruction in Treatment of Recurrent Patellar Dislocation

文章编号:

1005-0205(2017)08-0035-04

作者:

吴锦秋¹ 何海溶¹ 余欢¹ 常旭东² 王荟臻² 兰如华² 陈振东² 戴刚¹

1.甘肃省中医院关节骨二科(兰州,730050)
2.兰州大学中西医结合学院

Author(s):

WU Jinqiu¹ HE Hairong¹ YU Huan¹ CHANG Xudong² WANG Huizhen² LAN Ruhua² CHEN Zhendong² DAI Gang¹

1.Second Department of Orthopedics,Gansu Hospital of Traditional Chinese Medicine, Lanzhou 730050, China;
2.School of Integrated Chinese and Western Medicine,Lanzhou University, Lanzhou 730000, China.

关键词:

单骨道:双锚钉;  内侧髌股韧带;  重建;  髌骨脱位

Keywords:

single tunnel;  double anchor;  medial patellofemoral ligament;  reconstruction;  patella dislocation

分类号:

R684.7

文献标志码:

A

摘要:

目的:回顾性分析自体肌腱移植髌骨单骨道与髌骨双锚钉两种方法重建内侧髌股韧带治疗复发性髌骨脱位的临床疗效差异。方法:2012年6月至2015年3月到本科就诊的复发性髌骨脱位患者共58例。采用自体肌腱移植髌骨单骨道重建内侧髌股韧带治疗复发性髌骨脱位患者32例(对照组):其中男10例,女22例; 年龄16～28岁,平均22.5岁; 病程为4个月～6年。采用自体肌腱移植髌骨双锚钉重建内侧髌股韧带治疗复发性髌骨脱位患者26例(试验组):其中男7例,女19例:年龄16～28岁,平均21.8岁; 病程为4个月～6年。术前主要症状表现为膝关节不稳、肿胀,查体恐惧试验阳性,术前IKDC评分为42.3±11.5、Kujala评分为53.4±12.5,最后一次随访评估IKDC评分、Kujala评分、髌骨稳定性和X线片影像学异常。结果:两组患者伤口均Ⅰ期愈合,所有患者均获得随访,随访时间18～30个月,平均23.9个月,全部患者术后膝关节稳定,无髌骨骨折和再脱位发生,关节活动度无受限,髌骨恐惧试验阴性。对照组患者1例术后出现髌骨倾斜,余患者髌骨轴位片显示髌股关节解剖关系均恢复正常。试验组患者髌股关节解剖关系无明显异常。两组患者末次随访IKDC评分分别为72.3±11.7和83.2±10.8,与术前比较,P<0.01,差异有统计学意义; 两组患者末次随访Kujala 评分分别为86.3±8.7和87.0±9.8,与术前比较,P<0.01,差异有统计学意义。两组间差异无统计学意义(P>0.05)。结论:自体肌腱移植髌骨单骨道重建内侧髌股韧带治疗复发性髌骨脱位与双锚钉重建可取得相同的临床效果。

Abstract:

Objective: To compare reconstruction of medial patellofemoral ligament with autologous tendon graft in single tunnel and patellar double anchors in the treatment of recurrent patellar dislocation. Methods: 58 patients with recurrent patellar dislocation were enrolled in our department from June 2012 to March 2015. 32 patients were treated with autogenous tendon graft patellar bone reconstruction. There were 10 males and 22 females, aged 16～28 years, mean 22.5 years, the duration was 4 months to 6 years. 26 patients were treated with autologous tendon graft patellar double anchor to repair medial patellofemoral ligament, including 7 males and 19 females, aged 16～28 years, mean 21.8 years, the duration was of 4 months to 6 years. Preoperative primary symptoms were knee instability, swelling, fear test positive. The preoperative IKDC score was 42.3+11.5, and the Kujala score was 53.4 + 12.5. At the last follow-up visit, abnormal IKDC scores, Kujala scores, patellar stability and radiographs were assessed. Results: Primary wound healing was achieved in all two groups. All patients were followed up for 18 months-30 months, with an average of 23.9 months. All patients had stable knee joint, no patella fracture and dislocation occurred. The degree of joint mobility was unrestricted, patellar fear test negative. In the first group, 1 patient had postoperative patellar tilt, and the patellar axial radiograph of the other patients showed that the patellofemoral joint anatomy returned normal. There was no patellofemoral joint abnormality in the second group. At the last follow-up the IKDC scores of the two groups were 72.3±11.7 and 83.2±10.8, respectively. Compared with those preoperative, the difference was statistically significant(P<0.01). The Kujala scores of the two groups were 86.3±8.7 and 87.0±9.8 respectively. Compared with those preoperative, the difference was statistically significant(P<0.01). There was no significant difference between the two groups. Conclusion: Reconstruction of medial patellofemoral ligament with autologous tendon graft in single tunnel and patellar double anchors can achieve the same clinical effect in the treatment of recurrent patellar dislocation.

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更新日期/Last Update: 2017-08-15