84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]米豫飛,蘇春霞,鄒春雨,等.經(jīng)髕骨打結(jié)固定移植肌腱髕骨端解剖重建內(nèi)側(cè)髕股韌帶治療復(fù)發(fā)性髕骨脫位的臨床研究[J].中醫(yī)正骨,2020,32(06):12-17.
　MI Yufei,SU Chunxia,ZOU Chunyu,et al.A clinical study of transpatellar knotting fixation of patellar end of transplanted tendon in the surgery of anatomical reconstruction of medial patellofemoral ligament for treatment of recurrent patellar dislocation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(06):12-17.
點擊復(fù)制

經(jīng)髕骨打結(jié)固定移植肌腱髕骨端解剖重建內(nèi)側(cè)髕股韌帶治療復(fù)發(fā)性髕骨脫位的臨床研究()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年06期
頁碼:
12-17
欄目:
臨床研究
出版日期:
2020-06-20

文章信息/Info

Title:
A clinical study of transpatellar knotting fixation of patellar end of transplanted tendon in the surgery of anatomical reconstruction of medial patellofemoral ligament for treatment of recurrent patellar dislocation
作者:
米豫飛; 蘇春霞; 鄒春雨; 楊瀾波; 喬清奎; 王戰(zhàn)朝
(河南省洛陽正骨醫(yī)院河南省骨科醫(yī)院,河南洛陽471002)
Author(s):
MI Yufei; SU Chunxia; ZOU Chunyu; YANG Lanbo; QIAO Qingkui; WANG Zhanchao
Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China
關(guān)鍵詞:
髕骨脫位;  復(fù)發(fā);  內(nèi)側(cè)髕股韌帶;  臨床試驗
Keywords:
patellar dislocation;  recurrence;  medial patellofemoral ligament;  clinical trial
摘要:
目的:探討經(jīng)髕骨打結(jié)固定移植肌腱髕骨端解剖重建內(nèi)側(cè)髕股韌帶治療復(fù)發(fā)性髕骨脫位的臨床療效和安全性。方法:回顧性分析采用解剖重建內(nèi)側(cè)髕股韌帶治療的60例復(fù)發(fā)性髕骨脫位患者的病例資料,其中移植肌腱髕骨端采用經(jīng)髕骨打結(jié)固定者30例(打結(jié)固定組)、采用帶線錨釘固定者30例(錨釘固定組)。比較2組患者的Lysholm評分、Kujala評分、屈膝30°時的髕骨傾斜角和髕骨適合角、髕骨脫位復(fù)發(fā)及并發(fā)癥發(fā)生情況。結(jié)果:所有患者均獲得隨訪,隨訪時間為6～18個月,中位數(shù)10個月。18例行脛骨結(jié)節(jié)內(nèi)移的患者,脛骨結(jié)節(jié)均骨性愈合。①Lysholm評分。術(shù)前與術(shù)后6個月,2組患者Lysholm評分比較,差異均無統(tǒng)計學(xué)意義[(60.5±6.6)分,(58.4±7.6)分,t=0.243,P=0.404;(88.6±3.2)分,(87.8±4.6)分,t=0.354,P=0.362]; 術(shù)后6個月,2組患者Lysholm評分均較術(shù)前提高(t=-2.864,P=0.003; t=-3.057,P=0.002)。②Kujala評分。術(shù)前與術(shù)后6個月,2組患者Kujala評分比較,差異均無統(tǒng)計學(xué)意義[(53.5±5.2)分,(54.2±3.5)分,t=0.294,P=0.385;(80.9±7.6)分,(81.7±5.6)分,t=-0.287,P=0.388]; 術(shù)后6個月,2組患者Kujala評分均較術(shù)前提高(t=-3.364,P=0.001; t=-3.223,P=0.001)。③屈膝30°時的髕骨傾斜角。術(shù)前與術(shù)后6個月,2組患者屈膝30°時的髕骨傾斜角比較,差異均無統(tǒng)計學(xué)意義(12.5°±3.2°,12.3°±2.5°,t=0.326,P=0.373; 4.5°±2.5°,4.1°±2.7°,t=0.426,P=0.336); 術(shù)后6個月,2組患者屈膝30°時的髕骨傾斜角均較術(shù)前減小(t=1.986,P=0.028; t=2.183,P=0.018)。④屈膝30°時的髕骨適合角。術(shù)前與術(shù)后6個月,2組患者屈膝30°時的髕骨適合角比較,差異均無統(tǒng)計學(xué)意義(9.5°±1.2°,10.9°±2.3°,t=0.185,P=0.427; 1.5°±1.7°,1.9°±1.5°,t=-0.396,P=0.347); 術(shù)后6個月,2組患者屈膝30°時的髕骨適合角均較術(shù)前減小(t=2.426,P=0.010; t=2.537,P=0.008)。打結(jié)固定組3例、錨釘固定組2例發(fā)生切口脂肪液化,經(jīng)換藥治療后愈合; 打結(jié)固定組和錨釘固定組各有2例發(fā)生膝關(guān)節(jié)屈曲功能障礙,行麻醉下手法松解后恢復(fù)正常。均無髕骨骨折及脫位。2組患者的并發(fā)癥發(fā)生率和髕骨脫位復(fù)發(fā)率比較,差異均無統(tǒng)計學(xué)意義(P=1.000)。結(jié)論:在解剖重建內(nèi)側(cè)髕股韌帶治療復(fù)發(fā)性髕骨脫位時,移植肌腱髕骨端采用經(jīng)髕骨打結(jié)固定與帶線錨釘固定的短期療效及安全性相當。
Abstract:
Objective:To explore the clinical curative effects and the safety of transpatellar knotting fixation of patellar end of transplanted tendon in the surgery of anatomical reconstruction of medial patellofemoral ligament(MPFL)for treatment of recurrent patellar dislocation.Methods:The medical records of 60 patients who received anatomical reconstruction of MPFL for treatment of recurrent patellar dislocation were analyzed retrospectively.The patellar end of transplanted tendon was fixed by transpatellar knotting(knotting fixation group)and suture anchors(anchor fixation group)respectively,30 cases in each group.The Lysholm scores,Kujala scores,patellar tilt angle(PTA)and patellar congruence angle(PCA)at 30 degrees of knee flexion,recurrence of patellar dislocation and complications were compared between the 2 groups.Results:All patients in the 2 groups were followed up for 6-18 months with a median of 10 months.Anteromedial tibial tubercle transfer was performed on 18 patients,and all patients got bone union in tibial tubercles.There was no statistical difference in Lysholm scores between the 2 groups before the surgery and at 6 months after the surgery(60.5+-6.6 vs 58.4+-7.6 points,t=0.243,P=0.404; 88.6+-3.2 vs 87.8+-4.6 points,t=0.354,P=0.362).The Lysholm scores increased in the 2 groups at 6 months after the surgery compared to pre-surgery(t=-2.864,P=0.003; t=-3.057,P=0.002).There was no statistical difference in Kujala scores between the 2 groups before the surgery and at 6 months after the surgery(53.5+-5.2 vs 54.2+-3.5 points,t=0.294,P=0.385; 80.9+-7.6 vs 81.7+-5.6 points,t=-0.287,P=0.388).The Kujala scores increased in the 2 groups at 6 months after the surgery compared to pre-surgery(t=-3.364,P=0.001; t=-3.223,P=0.001).There was no statistical difference in PTA at 30 degrees of knee flexion between the 2 groups before the surgery and at 6 months after the surgery(12.5+-3.2 vs 12.3+-2.5 degrees,t=0.326,P=0.373; 4.5+-2.5 vs 4.1+-2.7 degrees,t=0.426,P=0.336).The PTA at 30 degrees of knee flexion decreased in the 2 groups at 6 months after the surgery compared to pre-surgery(t=1.986,P=0.028; t=2.183,P=0.018).There was no statistical difference in PCA at 30 degrees of knee flexion between the 2 groups before the surgery and at 6 months after the surgery(9.5+-1.2 vs 10.9+-2.3 degrees,t=0.185,P=0.427; 1.5+-1.7 vs 1.9+-1.5 degrees,t=-0.396,P=0.347).The PCA at 30 degrees of knee flexion decreased in the 2 groups at 6 months after the surgery compared to pre-surgery(t=2.426,P=0.010; t=2.537,P=0.008).The incision fat liquefaction was found in 3 patients in knotting fixation group and 2 patients in anchor fixation group,and the incisions healed after dressing change.The knee flexion dysfunction was found in 2 patients in knotting fixation group and 2 patients in anchor fixation group,and the patients recovered after treatment with manipulation release under anesthesia.No complications such as patellar fracture and dislocation were found in the 2 groups.There was no statistical difference in complication incidence rate and patellar dislocation recurrence rate between the 2 groups(P=1.000).Conclusion:The transpatellar knotting fixation and suture anchor fixation of patellar end of transplanted tendon are similar to each other in short-term curative effects and safty in surgery of anatomical reconstruction of MPFL for treatment of recurrent patellar dislocation.

參考文獻/References:

[1]ALVAREZ O,STEENSEN R N,RULLKOETTER P J,et al.Computational approach to correcting joint instability in patients with recurrent patellar dislocation[J].J Orthop Res,2020,38(4):768-776.
[2]SCHNEIDER D K,GRAWE B,MAGNUSSEN R A,et al.Outcomes after isolated medial patellofemoral ligament reconstruction for the treatment of recurrent lateral patellar dislocations:a systematic review and meta-analysis[J].Am J Sports Med,2016,44(11):2993-3005.
[3]JOHNSON D S,TURNER P G.Management of the first-time lateral patellar dislocation[J].Knee,2019,26(6):1161-1165.
[4]STEIN B E S,GRUBER S,BRADY J M.MPFL in first-time dislocators[J].Curr Rev Musculoskelet Med,2018,11(2):182-187.
[5]HUNTINGTON L S,WEBSTER K E,DEVITT B M,et al.Factorsassociated with an increased risk of recurrence after a first-time patellar dislocation:a systematic review and meta-analysis[JOL].Am J Sports Med,2019[2019-10-20].http:sage.cnpereading.comparagraphdownload10.11770363546519888467.
[6]DESAI V S,TAGLIERO A J,PARKES C W,et al.Systematic review of medial patellofemoral ligament reconstruction techniques:comparison of patellar bone socket and cortical surface fixation techniques[J].Arthroscopy,2019,35(5):1618-1628.
[7]劉繼軍,武琪,段力軍,等.帶袢鈦板單骨道重建與骨槽帶線錨釘雙束重建內(nèi)側(cè)髕股韌帶治療復(fù)發(fā)性髕骨脫位的療效比較[J].中華骨與關(guān)節(jié)外科雜志,2018,11(11):849-853.
[8]NOYES F R.Noyes’kneedisorders:surgery,rehabilitation,clinical outcomes[M].2nd ed.Philadelphia:Elsevier Inc,2017:980-983.
[9]SMITH M K,WERNER B C,DIDUCH D R.Avoidingcomplications with MPFL reconstruction[J].Curr Rev Musculoskelet Med,2018,11(2):241-252.
[10] SHAH J N,HOWARD J S,FLANIGAN D C,et al.A systematic review of complications and failures associated with medial patellofemoral ligament reconstruction for recurrent patellar dislocation[J].Am J Sports Med,2012,40(8):1916-1923.
[11] 馮華,張輝.髕股關(guān)節(jié)不穩(wěn)定臨床評估與治療[M].北京:人民軍醫(yī)出版社,2014:16-17.
[12] DEJOUR D,COULTRE B L.Osteotomies in patello-femoral instabilities[J].Sports Med Arthrosc Rev,2007,15(1):39-46.
[13] INSALL J,FALVO K A,WISE D W.Chondromalacia patellae.A prospective study[J].J Bone Joint Surg Am,1976,58(1):1-8.
中醫(yī)正骨2020年6月第32卷第6期J Trad Chin Orthop Trauma,2020,Vol.32,No.6(總417)
(總418)中醫(yī)正骨2020年6月第32卷第6期J Trad Chin Orthop Trauma,2020,Vol.32,No.6
[14] MCGEE T G,COSGAREA A J,MCLAUGHLIN K,et al.Rehabilitation after medial patellofemoral ligament reconstruction[J].Sports Med Arthrosc Rev,2017,25(2):105-113.
[15] LYSHOLM J,GILLQUIST J.Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale[J].Am J Sports Med,1982,10(3):150-154.
[16] KUJALA U M,JAAKKOLA L H,KOSKINEN S K,et al.Scoring of patellofemoral disorders[J].Arthroscopy,1993,9(2):159-163.
[17] FUCENTESE S F.Patellofemoralinstability[J].Orthopade,2018,47(1):77-86.
[18] TRINH T Q,FERREL J R,BENTLEY J C,et al.Theanatomy of the medial patellofemoral ligament[J].Orthopedics,2017,40(4):e583-e588.
[19] CHOUTEAU J.Surgical reconstruction of the medial patellofemoralligament[J].Orthop Traumatol Surg Res,2016,102(1 Suppl):S189-S194.
[20] SONG J G,KANG S B,OH S H,et al.Medialsoft-tissue realignment versus medial patellofemoral ligament reconstruction for recurrent patellar dislocation:systematic review[J].Arthroscopy,2016,32(3):507-516.
[21] 姚俊娜,權(quán)松濤,馮偉,等.雙束半腱肌肌腱解剖重建MPFL治療復(fù)發(fā)性髕骨脫位[J].中醫(yī)正骨,2018,30(8):54-57.
[22] VASSO M,CORONA K,TORO G,et al.Anatomic double-bundle medial patellofemoral ligament reconstruction with autologous semitendinosus:aperture fixation both at the femur and the patella[J].Joints,2017,5(4):256-260.
[23] AZAR F M,BEATY J H,CANALEST.Campbell’s operative orthopaedics[M].13rd ed.Philadelphia:Elsevier Inc,2017:11-14.
[24] PATEL N K,DE SA D,VASWANI R,et al.Kneeflexion angle during graft fixation for medial patellofemoral ligament reconstruction:a systematic review of outcomes and complications[J].Arthroscopy,2019,35(6):1893-1904.
[25] GE?EIN M,ROESSLER P P,SCHüTTLER K F,et al.Complications and failure of MPFL reconstruction with free tendon grafts in cases of patellofemoral instability[J].Technol Health Care,2015,23(5):659-666.

相似文獻/References:

[1]楊久山.關(guān)節(jié)鏡下髕外側(cè)支持帶松解聯(lián)合內(nèi)側(cè)髕股韌帶重建 治療復(fù)發(fā)性髕骨脫位[J].中醫(yī)正骨,2015,27(08):38.
[2]陳麗,張曉華,司珂.耳穴貼壓和中藥敷臍在兒童習(xí)慣性髕骨脫位伸膝裝置重建術(shù)后護理中的應(yīng)用[J].中醫(yī)正骨,2018,30(05):79.
[3]姚俊娜,權(quán)松濤,馮偉,等.雙束半腱肌肌腱解剖重建內(nèi)側(cè)髕股韌帶 治療復(fù)發(fā)性髕骨脫位[J].中醫(yī)正骨,2018,30(08):54.
[4]張麟,陳洪波,周廣文,等.“治病求本，筋骨并重”理論及其對治療復(fù)發(fā)性髕骨脫位的指導(dǎo)意義[J].中醫(yī)正骨,2019,31(12):54.
[5]陳犖,顧圣華,章培峰,等.關(guān)節(jié)鏡輔助定位股骨隧道重建內(nèi)側(cè)髕股韌帶治療復(fù)發(fā)性髕骨脫位的臨床研究[J].中醫(yī)正骨,2021,33(07):11.
　CHEN Luo,GU Shenghua,ZHANG Peifeng,et al.A clinical study of femoral tunnel positioning assisted by arthroscopy in medial patellofemoral ligament reconstruction for treatment of recurrent patellar dislocation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(06):11.
[6]于開凡,陳日高,何東霖,等.復(fù)發(fā)性腰椎間盤突出癥影像學(xué)危險因素的研究進展[J].中醫(yī)正骨,2024,36(01):50.
[7]鄔博來,鄧佳鑫,王小軍,等.改良股四頭肌成形術(shù)聯(lián)合改良內(nèi)側(cè)髕股韌帶重建術(shù)治療固定性髕骨脫位[J].中醫(yī)正骨,2025,37(03):73.
[8]謝興文,呂立桃,王春亮,等.復(fù)發(fā)性髕骨脫位的病因及診治進展[J].中醫(yī)正骨,2016,28(08):66.

備注/Memo

備注/Memo:
(收稿日期:2020-01-05本文編輯:李曉樂)通訊作者:米豫飛E-mail:[email protected]
更新日期/Last Update: 2020-10-10