内侧髌股韧带重建治疗髌骨脱位的基础地位与联合术式进展：文献综述

The Fundamental Role of Medial Patellofemoral Ligament Reconstruction in Treating Patellar Dislocation and Advances in Combined Surgical Techniques: A Literature Review

摘要: 本综述综合分析了治疗髌骨脱位的相关文献，目的在于深入探讨其发展现状、应用场景与未来趋势，为髌股韧带重建治疗髌骨脱位提供理论支持和实践参考。通过梳理并筛选国内外近三年关于髌骨脱位相关文献的方法，系统呈现了该领域的主要研究现状。在髌骨脱位造成软骨损伤方面，已有研究表明，复发性髌骨脱位可导致膝关节特定部位更严重的软骨损伤但髌骨病变的存在或级别与脱位次数无关，并且髌骨脱位次数对软骨损伤严重程度的影响尚未确定。在髌股韧带重建相比主动康复方面，研究表明髌股韧带重建优于主动康复。在髌股韧带联合其他韧带重建方面，研究显示髌股韧带联合髌胫韧带重建有更好的效果，但是否还能联合其他韧带重建尚未确定。在髌股韧带重建结合外侧松解治疗髌骨脱位方面，目前仍未有足够的证据支持外侧松解的利弊及适应症。综上所述，髌股韧带重建术是治疗髌骨脱位的核心治疗手段，但各类新型重建技术在临床应用中的可行性仍存在待解决的问题。本文献综述为后续进一步深入研究髌股韧带重建提供了方向和思路，包括联合其他韧带重建、外侧松解等。

Abstract: This comprehensive review analyzes the relevant literature on the treatment of patellar dislocation, aiming to delve into its current development status, application scenarios, and future trends, and provide theoretical support and practical reference for the treatment of patellar dislocation with patellofemoral ligament reconstruction. By combing and screening domestic and international literature on patellar dislocation in the past three years, the main research status in this field is systematically presented. Regarding cartilage damage caused by patellar dislocation, studies have shown that recurrent patellar dislocation can lead to more severe cartilage damage in specific areas of the knee joint, but the presence or grade of patellar lesions is not related to the number of dislocations, and the impact of the number of patellar dislocations on the severity of cartilage damage has not been determined. In terms of patellofemoral ligament reconstruction compared to active rehabilitation, research indicates that patellofemoral ligament reconstruction is superior to active rehabilitation. Regarding the combination of patellofemoral ligament reconstruction with other ligament reconstructions, studies have revealed that the combination of patellofemoral ligament and patellotibial ligament reconstruction yields better results, but whether it can be combined with other ligament reconstructions remains undetermined. Currently, there is insufficient evidence to support the benefits and indications of lateral release in the treatment of patellar dislocation with patellofemoral ligament reconstruction. In summary, patellofemoral ligament reconstruction serves as the cornerstone for the treatment of patellar dislocation, but it still faces challenges regarding the feasibility of various new reconstruction methods in clinical practice. This literature review provides directions and ideas for further in-depth studies on patellofemoral ligament reconstruction, including combinations with other ligament reconstructions, lateral release, and more.