[精品]改良单骨道双束重建内侧髌股韧带治疗复发性髌骨脱位的临床研究.doc

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1、改良单骨道双束重建内侧離股韧带治疗复发性離骨脱位的临床研究改良单骨道双束重建内侧離股韧带治疗复发性離骨脱位的临床研究【摘耍】目的：探讨改良单骨道双束重建内侧離股韧带治疗复发性離骨脱的临床应用价值。方法：对33例复发性験骨脱位患者行改良单骨道技术双束重建内侧離股韧带联合关节镜下離骨外侧支持带松解加胫骨结节内移治疗。术后观察切口愈合情况，離骨稳定性，膝关节X片检查测量对比术前、术后骨宾骨适配角、離骨倾斜角、外侧離股角，采用Lysholm和Kujala评分评佔膝关节功能。结果：33例均获随访，时间8〜15个月，平均(12±3・1)月。切口按期愈合，无感染，離骨稳定，运动能力恢复，

2、33例病例均无離骨再脱位，两组患者的术前、术后韻骨适配角为(21.8±5.9)°、(-2・5±4・0)。,離骨倾斜角(24.9±5.8)°、(14.8±4.2)°,外侧離股角(-6・1±2・3)°、(5.4±1.6)°oLysholm评分术前、术后分别为(35.10±9.31)分和(89.11±5.21)分，Kujala评分术前、术后分别为(36.26±13.36)分和(90.45±4,55)分，比较差异有统计学意义(P<0.05)o结论：改良单骨道双束重建技术重建内侧離股韧带具有操作简单，牢固可靠、并发症少、住院费用低的优点，联合关节镜下離骨外侧支持带松解加胫骨结节内移，

3、可取的良好的治疗效果。【关键词】改良单骨道；双束重建；内侧離股韧带；離骨脱位[Abstract】Objective：Toinvestigatethepotentialclinicalvalueofimprovedsinglebonetunneldouble~bundlereconstructionmethodinthetreatmentofrecurrentpatellardisiocation.Method：Performimprovedsinglebonetunneldouble~bundlereconstructiontechniquetoreconstructmed

4、ialpatollofemoral1igamentwithcombiningtreatmentsoflateralretinaculumreleaseandmedialtibialtubercletransferonthirty—threerecurrentpatellardislocationpatients.Afteroperation,checktheincisionhealingcondition,patellarstabi1ity,kneeXandcomparepatellaradapterangle,patellartiltangleandlateralpate

5、llofemoralangletoevaluatethekneefunctionbyusingLysholmandKujalascore・Result：Allfollowupsofthirty-threecaseslastedfor8to15months・Incisionhealingonschedule,noinfection,patellarstableandreversionofmotorability・Allthirty-threecasesshowednosignofpatellardislocation.Twogroupsofpatellaradapterang

6、le(21.8±5.9)°,(一2・5±4.0)°,patellartiltangle(24.9±5.8)°,(14.8+4.2)°andlateralpatellofemoralangle(一6.1±2.3)°,(5.4±1・6)°beforeandafteroperationwereasshown.Lysholmscorebeforeandafteroperationwererespectively(35.10+9.31)and(89.11±5.21).Kujalascorebeforeandafteroperationwererespectivel(36.26±13.

7、36)and(90.45±4.55)・Datadiffereneeshowedstatisticalsignificance・Conclusion：Usingimprovedsinglebonetunneldouble-bundlereconstructiontechniquetoreconstructmedialpatollofemoralligamentiseasytoperform,verystable,economicalandhasfewcompliments・Combiningwithlateralre