髌股韧带髌胫韧带联合重建治疗复发性髌骨脱位
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作者单位:

东营市人民医院,山东东营 257091

作者简介:

宁波,主任医师,研究方向:运动医学,(电子信箱)dongying197903@163.com

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中图分类号:

R684.7

基金项目:

山东省医药卫生科技发展计划面上项目(编号:2019WS035)


Patellofemoral ligament and patellotibial ligament combined reconstruction for recurrent patellar dislocation
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People's Hospital of Dongying City, Dongying 257091 , Shandong, China

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    摘要:

    [目的] 探讨内侧髌股韧带 (medial patellofemoral ligament, MPFL) 和内侧髌胫韧带 (medial patellotibial ligament, MPTL)联合重建治疗复发性髌骨脱位的临床疗效。[方法]2018 年 5 月-2021 年 9 月 27 例行 MPFL 和 MPTL 重建术治疗复发性髌骨脱位。采用保留胫骨止点的自体半腱肌腱重建 MPFL 和 MPTL。评价临床及影像结果。[结果] 27 例患者均顺利完成手术,无血管神经损伤、下肢静脉血栓形成等严重并发症。随术前、术后 3 个月和末次随访的时间推移,VAS 评分 [(6.3±1.1), (1.6±0.5), (0.5±0.5), P<0.001] 显著减少,Kujala [(51.9±3.0), (84.0±1.2), (93.2±1.1), P<0.001]、Lysholm 评分 [(52.1±3.9), (83.1±2.6), (88.0±2.9), P<0.001]、膝伸屈 ROM [(111.9±3.1)°, (122.6±1.7)°, (127.8±1.6)°, P<0.001] 均显著增加。影像方面,髌骨倾斜角 [(21.4± 1.8)°, (8.1±0.8)°, (7.3±0.6)°, P<0.001]、髌外移 [阳性/阴性, (13/14), (2/25), (2/25), P<0.001] 均显著改善,TT-TG 无显著变化 (P> 0.05)。[结论] MPFL 与 MPTL 联合重建能有效治疗复发性髌骨脱位,改善膝关节功能,减轻疼痛,是一种安全有效的治疗方法。

    Abstract:

    [Objective] To evaluate the clinical efficacy of combined reconstruction of medial patellotibial ligament (MPFL) and medial patellotibial ligament (MPTL) in the treatment of recurrent patellar dislocation. [Methods] A total of 27 patients underwent MPFL and MPTL combined reconstruction using autogenous semitendinous tendon with tibial insertion preserved for recurrent patellar dislocation from May 2018 to September 27, 2021. Clinical and imaging results were evaluated. [Results] All 27 patients had operation performed successfully without serious complications such as blood vessel, nerve injury and lower limb venous thrombosis. As time elapsed preoperatively, 3 months postoperatively and the latest follow-up, the VAS score [(6.3±1.1), (1.6±0.5), (0.5±0.5), P<0.001] significantly reduced, Kujala score [(51.9±3.0), (84.0±1.2), (93.2±1.1), P<0.001], Lysholm score[(52.1±3.9), (83.1±2.6), (88.0±2.9), P<0.001], knee extension-flexion ROM [(111.9±3.1)°, (122.6±1.7)°, (127.8±1.6)°, P<0.001] significantly increased. As for image, the patellar tilt angle [(21.4±1.8)°, (8.1± 0.8)°, (7.3±0.6)°, P<0.001], lateral patellar displacement [positive/negative, (13/14), (2/25), (2/25), P<0.001] were significantly improved over time, whereas the TT-TG remained unchanged significantly (P>0.05). [Conclusion] MPFL and MPTL combined reconstructions do effectively treat recurrent patellar dislocation, improve knee joint function, reduce pain, and are safe and effective treatment technique.

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宁波,宋燕磊,隋淑湘,等. 髌股韧带髌胫韧带联合重建治疗复发性髌骨脱位[J]. 中国矫形外科杂志, 2025, 33 (16): 1529-1532. DOI:10.20184/j. cnki. Issn1005-8478.110636.
NING Bo, SONG Yan-lei, SUI Shu-xiang, et al. Patellofemoral ligament and patellotibial ligament combined reconstruction for recurrent patellar dislocation[J]. Orthopedic Journal of China , 2025, 33 (16): 1529-1532. DOI:10.20184/j. cnki. Issn1005-8478.110636.

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  • 收稿日期:2024-09-01
  • 最后修改日期:2025-04-01
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  • 在线发布日期: 2025-08-21
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