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1目的探讨关节镜下腘绳肌腱重建内侧髌股韧带术治疗青少年习惯性髌骨脱位的临床疗效。2方法 2013年12月~2016年2月来我院就诊17例(18膝)青少年习惯性髌骨脱位患者,术前均行双下肢全长片及膝关节CT平扫等影像学资料测量髌骨Q角、胫骨结节-滑车间距(TT-TG值),17例(18膝)患者术前及术后膝关节功能疗效评比均使用Lysholm评分、IKDC功能评分、Kujala评分。3结果所有患者随访时间3~30个月,平均(14.47±7.67)个月,随访过程中无脱落。术后所有患者膝关节功能较术前明显改善,且髌骨没有发生再次脱位的现象,髌骨轴位片示膑股关节面良好,髌骨外推以及恐惧实验均转为阴性。术前与术后膝关节Lysholm评分[(53.778±9.334)、(86.889±7.918)],IKDC评分[(51.389±8.952)、(85.833±10.007)],Kujala膝关节主观功能评分[(50.556±8.403)、(87.944±8.349)],差异均有统计学意义(P均<0.05)。4结论关节镜下腘绳肌腱重建内侧髌股韧带术治疗青少年髌骨习惯性脱位,患者术后膝关节功能得到明显提高,其疗效值得肯定。
1 Objective To investigate the clinical efficacy of arthroscopic hamstring tendon reconstruction medial patellofemoral ligament in the treatment of habitual patellar dislocation in young patients. 2 Methods From December 2013 to February 2016, 17 patients (18 knees) with habitual patellar dislocation in our hospital were treated with imaging data of full-length double-leg lower extremity and CT scan of knee joint The TT-TG value, Lysholm score, IKDC function score and Kujala score were used in 17 patients (18 knees) before and after operation. 3 Results All patients were followed up for 3 to 30 months, with an average of (14.47 ± 7.67) months, no fall off during follow-up. Postoperative knee function was significantly improved in all patients compared with that before operation, and no dislocation of the patella occurred. The patellar axis showed that the sliver joint surface was good, and the patella extrapolation and fear tests turned negative. The Lysholm score [(53.778 ± 9.334), (86.889 ± 7.918), IKDC score [(51.389 ± 8.952), (85.833 ± 10.007)], Kjala knee subjective functional score [(50.556 ± 8.403 ), (87.944 ± 8.349)], the differences were statistically significant (all P <0.05). Conclusions Arthroscopic reconstruction of the medial patellofemoral ligament with pontine tendon treatment of patellar habitual dislocation in young patients, patients with postoperative knee function has been significantly improved, its efficacy is worthy of recognition.