关节镜辅助下综合治疗髌股关节不稳的研究

Study on comprehensive treatment patellofemoral instability under arthroscopy

摘要:

目的 探讨关节镜辅助下综合治疗髌股关节不稳定的临床疗效。 方法 2009年1月～2012年12月，新疆医科大学第一附属医院骨病运动损伤科共收治髌股关节不稳236例248膝。所有患者均在关节镜辅助下行梯度综合治疗。术前术后对患者行IKDC、Lysholm评分和Kujala评分，并拍摄髌骨轴位片，测量适合角、外侧髌股角、髌骨倾斜角、髌骨移位距离、髌骨外移距离及Q角。 结果 成功随访218例226膝（91.9%），随访时间3～51个月，平均29.8个月。末次随访时拍摄髌骨轴位片，测量适合角、外侧髌股角、髌骨倾斜角、髌骨移位距离、髌骨外移距离分别为：（-4.1±3.2）°、（9.2±3.4）°、（3.7±2.1）°、（2.1±1.5） mm、（3.4±1.4） mm，测量Q角为（12.4±3.6），上述指标较术前差异有显著性（P <0.05）。末次随访时Lysholm评分、Kujala评分及IKDC分别为：（90.8±5.1）、（89.6±3.9）、（92.6±4.3），较术前相比差异有显著性（P <0.05）。 结论 关节镜辅助下综合治疗髌股关节不稳定疗效肯定。

Abstract:

【Objective】 To explore the effectiveness of arthroscopic treatment of instability of patellofemoral joint. 【Methods】 The total of 236 cases including 248 knees patellarfemoral instability from January 2009 to December 2012 in our department were treated and analyzed. 【Results】 A total of 218 patients with 226 knees were followed up for 3 to 51 months, an average of 29.8 months; there was significant difference in congruence angle, lateral patellofemoral angle, patellar tilt angle, lateral patellar displacement, patellar displacement, or Q angle compared with preoperative at last follow-up (P >0.05). there was significant difference in Lysholm score, Kujala score and IKDC score compared with preoperative at last follow-up (P >0.05). 【Conclusion】 Arthroscopy is an effective method to treat instability of patellofemoral joint.