股骨前倾角增大对髌骨脱位患者术后 髌骨外倾角及临床预后的影响

Effect of Increased Femoral Anteversion on Postoperative Patellar Camber and Clinical Prognosis in Patients with Patellar Dislocation

摘要:

〔摘 要〕 目的：探究股骨前倾角增大对髌骨脱位患者内侧髌股韧带（MPFL）重建术后髌骨外倾角及临床预后的 影响。方法：选取 2019 年 8 月至 2020 年 12 月于深圳市第二人民医院运动医学科就诊的 36 例复发性髌骨脱位患者， 根据股骨前倾角是否＞ 25° 分为对照组和观察组，股骨前倾角＞ 25° 的患者分为观察组（16 例），股骨前倾角≤ 25° 的患者为对照组（20 例）。两组患者均行 MPFL 单束重建联合外侧支持带松解术。比较两组患者术后髌骨外倾角， 并使用 Lysholm 膝关节功能评分、Kujala 评分、国际膝关节文件委员会（IKDC）主观膝关节评分、Tegner 重返运动 评分比较两组患者手术前后膝关节功能及重返运动的能力。结果：观察组患者术后髌骨外倾角高于对照组，差异具有 统计学意义（P ＜ 0.05）；术后 9 个月，两组患者 Lysholm、Kujala、IKDC 评分较术前均有明显改善，差异均具有统 计学意义（P ＜ 0.05），但两组间评分差异无统计学意义（P ＞ 0.05）；术后 9 个月两组患者 Tegner 重返运动评分较 术前降低，差异均具有统计学意义（P ＜ 0.05），但两组间评分差异无统计学意义（P ＞ 0.05）。结论：股骨前倾角 增大的髌骨脱位患者行 MPFL 重建术后，其髌骨外倾角改善程度差于股骨前倾角正常的患者，但两组患者的临床预 后没有明显差别。

关键词:髌骨脱位;内侧髌股韧带;股骨前倾角;内侧髌股韧带重建术

Abstract:

〔Abstract〕 Objective To investigate the effect of increased femoral anteversion on patellar camber and clinical prognosis after medial patellofemoral ligament (MPFL) reconstruction in patients with patellar dislocation. Methods 36 patients with recurrent patellar dislocation who admitted to the Department of Sports Medicine of the Second People's Hospital of Shenzhen from August 2019 to December 2020 were selected and divided into a control group and an observation group according to whether the femoral anteversion was > 25°, patients with femoral anteversion angle > 25°were divided into observation group (16 cases), and patients with femoral anteversion angle ≤ 25°were divided into control group (20 cases). The patients in the two groups underwent single bundle MPFL reconstruction combined with lateral retinacular release. The postoperative patellar tilt angle was compared between the two groups, and the Lysholm knee function score, Kujala score, International Knee Documentation Committee (IKDC) subjective short form and Tegner score were used to compare the knee function and return–to–sport ability of the two groups before and after surgery. Results Postoperative patellar camber in the observation group was higher than that in the control group, and the difference was statistically significant (P < 0.05). Nine months after surgery, Lysholm, Kujala and IKDC scores in the two groups were significantly improved compared with those before surgery, with statistically significant differences (P < 0.05), but there was no statistically significant difference in scores between the two groups (P > 0.05). Tegner's reentry score 9 months after surgery was lower than that before surgery, and the difference was statistically significant (P < 0.05), but there was no statistically significant difference in scores between the two groups (P > 0.05). Conclusion Patients with femoral anteversion on patellar camber who underwent MPFL reconstruction have a worse improvement in patellar camber than patients with normal femoral anteversion, but there was no significant difference in clinical prognosis between the two groups

Key words:Patellar dislocation; Medial patellofemoral ligament; Femoral anteversion; Medial patellofemoral ligament reconstruction