自体股四头肌腱移植重建髌股内侧韧带治疗髌股脱位。回顾性儿科患者队列的临床和功能结局。

Acta ortopedica mexicana Pub Date : 2025-07-01
J I Pérez-Abdala, D Semeschenko, C Halliburton, S Bosio, M Puigdevall
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引用次数: 0

摘要

前言:使用自体股四头肌腱重建髌股内侧韧带(MPFL)治疗儿童髌骨股脱位是一种外科选择,与其他类型的移植物相比,可能具有优势。我们评估了一组儿科患者的临床和功能结果、恢复运动的比率和并发症。材料和方法:回顾性和描述性队列研究。采用自体股四头肌肌腱移植物重建髌股脱位的小儿复发性髌股脱位,伴或不伴其他手术。至少需要两年的随访。排除了先天性髌骨脱位、既往手术、结缔组织疾病和内侧髌骨脱位的患者。我们测量了Kujala功能评分,其最小临床重要差异(MCID)和Tegner活动量表。术前和术后Kujala和Tegner评分的差异采用Wilcoxon符号秩检验进行分析。结果:我们选择了9例患者(12个膝关节),平均年龄16.5岁。术前Kujala评分中位数为56分,四分位数范围(IQR)为51 ~ 65,术后Kujala评分中位数为99分(IQR 95100)。MCID为1,差异有统计学意义(p < 0.01)。术前Tegner评分中位数为6 (IQR 68.5),术后Tegner评分中位数为5.5 (IQR 47),差异有统计学意义(p = 0.02)。恢复运动的平均时间为6.5个月。共发现4例并发症。结论:应用自体股四头肌肌腱移植物重建小儿MPFL是一种可靠的选择,具有良好的临床和功能效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Surgical management of patellofemoral dislocation using an autologous quadriceps tendon graft for medial patellofemoral ligament reconstruction. Clinical and functional outcomes in a retrospective cohort of pediatric patients].

Introduction: medial patellofemoral ligament (MPFL) reconstruction using an autologous quadriceps tendon graft to treat patellofemoral dislocation in the pediatric population is a surgical alternative that may offer advantages compared to other types of grafts. We assessed clinical and functional outcomes, rate of return to sport, and complications in a cohort of pediatric patients.

Material and methods: retrospective and descriptive cohort study. Pediatric patients with recurrent patellofemoral dislocation treated with MPFL reconstruction using an autologous quadriceps tendon graft, with or without an additional procedure, were included. A minimum follow-up of two years was required. Patients with congenital patellofemoral dislocation, previous surgeries, connective tissue disorders, and medial patellar dislocation were excluded. We measured the Kujala functional score, its minimally clinically important difference (MCID), and the Tegner activity scale. The difference between preoperative and postoperative Kujala and Tegner scores was analyzed using the Wilcoxon signed-rank test.

Results: we selected nine patients (12 knees) with a mean age of 16.5 years. The median preoperative Kujala score was 56 with an interquartile range (IQR) of 51-65, and 99 (IQR 95100) postoperatively. A MCID and a statistically significant difference were achieved (p < 0.01). The median preoperative Tegner score was 6 (IQR 68.5) and 5.5 (IQR 47) postoperatively, with this difference being statistically significant (p = 0.02). The average time to return to sports was 6.5 months. Four complications were found.

Conclusions: MPFL reconstruction using autologous quadriceps tendon graft in pediatric patients is a reliable option with good clinical and functional outcomes.

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