[1]陈汉东 田向东** 王剑 朱光宇 谭冶彤 雷鸣 马晟 李述文 韩昶晓 黄叶.关节镜下髌骨外侧支持带松解术治疗髌骨外侧高压综合征的初步观察[J].中国微创外科杂志,2020,01(9):812-817.
　Chen Handong,Tian Xiangdong,Wang Jian,et al.Preliminary Observation of Arthroscopic Lateral Retinacular Release for the Treatment of Lateral Patellar Compression Syndrome[J].Chinese Journal of Minimally Invasive Surgery,2020,01(9):812-817.
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关节镜下髌骨外侧支持带松解术治疗髌骨外侧高压综合征的初步观察()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2020年9期
页码:
812-817
栏目:
临床研究
出版日期:
2020-09-25

文章信息/Info

Title:
Preliminary Observation of Arthroscopic Lateral Retinacular Release for the Treatment of Lateral Patellar Compression Syndrome
作者:
陈汉东 田向东** 王剑 朱光宇 谭冶彤 雷鸣 马晟 李述文 韩昶晓 黄叶
（北京中医药大学第三附属医院微创关节科，北京100029）
Author(s):
Chen Handong;  Tian Xiangdong;  Wang Jian;  et al.
Department of Minimally Invasive Joint Surgery, Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China
关键词:
髌骨外侧高压综合征; 髌骨外侧支持带松解术; 膝关节功能; 康复锻炼
Keywords:
Lateral patellar compression syndrome; Lateral retinacular release; Knee joint function; Rehabilitation exercise
文献标志码:
A
摘要:
目的探讨关节镜下髌骨外侧支持带松解术治疗髌骨外侧高压综合征(lateral patellar compression syndrome，LPCS)的临床疗效。方法选择2018年9月～2019年5月我科收治65例LPCS,剔除失访2例，根据治疗方式不同分为玻璃酸钠组与微创组，玻璃酸钠组采用玻璃酸钠关节腔内注射联合肢体功能训练治疗；微创组采用关节镜下髌骨外侧支持带松解术联合术后肢体功能训练。对治疗前后疼痛视觉模拟评分(Visual Analogue Scale，VAS)、Lysholm评分，患膝轴位X线、MRI髌骨倾斜角(patellar tilt angle，PTA)、髌股吻合角(congruence angle，CA)进行比较。结果63例随访6~11个月，平均8.8月。2组治疗后疼痛VAS评分均显著降低，微创组治疗后3、6个月疼痛VAS评分明显低于玻璃酸钠组（P<0.05）。2组患者Lysholm评分组间、时间、组别与时间的交互作用差异有统计学意义(P＜0.05)，且不同时间点比较差异均有统计学意义(P＜0.05)。2组患者CA、PTA治疗前与治疗后6个月以及2组间治疗后6个月比较差异均有统计学意义(P＜0.05)。微创组治疗LPCS的疗效明显优于玻璃酸钠组（Z=-2.714，P=0.007）。结论关节镜下髌骨外侧支持带松解术与关节腔内玻璃酸钠注射均能缓解LPCS患者膝前疼痛，改善膝关节活动功能，关节镜下外侧支持带松解术改善更显著。
Abstract:
ObjectiveTo investigate the effect of arthroscopic lateral retinacular release on knee joint function in patients with lateral patellar compression syndrome(LPCS). MethodsSixtyfive patients with LPCS who were admitted in our department from September 2018 to May 2019 were included. According to different treatment methods, they were divided into sodium hyaluronate group and minimally invasive group. The sodium hyaluronate group was treated with sodium hyaluronate intraarticular injection combined with function exercise, and the minimally invasive group was treated with arthroscopic lateral retinacular release combined with function exercise. The Visual Analogue Scale (VAS) and Lysholm score were used before and after treatment, and the patellar tilt angle (PTA) and congruence angle (CA) were measured in knee Xray axial view and MRI.ResultsAll the 63 cases were followed up for 6-11 months (mean, 8.8 months). The VAS scores of pain were significantly lower in both groups after treatment, and were lower in the minimally invasive group than those in the sodium hyaluronate group at 3 and 6 months after treatment (P<005). The Lysholm scores showed statistically significant differences between the two groups, interaction between groups and time points (P<005),with differences in intergroup at the same time point and intragroup at different time points being statistically significant (P<0.05). The differences of the CA and PTA in intragroup and intergroup were statistically significant(P<0.05). The curative effect in the minimally invasive group was significantly better than that in the sodium hyaluronate group (Z=-2.714, P=0007).ConclusionBoth arthroscopic lateral retinacular release and intraarticular sodium hyaluronate injection can relieve pain and improve knee joint function in patients with LPCS, and arthroscopic lateral retinacular release can improve symptoms more significantly.

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备注/Memo

备注/Memo:
基金项目：北京中医药大学横向课题基金项目（303-02-01-06-04）**通讯作者，Email:tianxd7802@sina.com
更新日期/Last Update: 2020-12-09