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目的：比较膝关节镜下两种手术方式治疗髌骨轨迹异常的远期疗效。方法2008年6月至2012年9月间共收治髌骨轨迹异常患者32例，随机分为两组， A组(n=14例)：采用膝关节镜下髌外侧支持带松解术；B组(n=18例)：采用膝关节镜下髌外侧支持带松解联合胫骨结节内移术。比较两组患者膝关节功能及影像学变化。结果31例患者获得随访，随访16～52个月，平均(37.13±4.35)个月。与术前相比，A、B组膝关节功能明显改善( P<0.05)，影像学方面，A组在髌骨适合角(CA)及外侧髌股角(LPA)方面，B组在Q角(QA)、CA及LPA方面有明显改善(P0.05)，术后B组QA明显低于，LPA明显高于A组(P0.05)。所有患者术后伤口I期愈合。结论膝关节镜技术治疗髌骨轨迹异常是一种微创、有效、可靠方法，能够大幅度改善膝关节功能，且膝关节镜下髌外侧支持带松解联合胫骨结节内移术疗效更佳。“,”Objective To compare the long-term theraputical effect of two knee arthroscopic surgery for patel ofemoral malalignment. Methods Knee arthroscopic surgery was performed in 32 patients with patel ofemoral malalignment from June 2008 to September 2012 in our hospital. Two methods were applied: (1)Group A: lateral patel a retinaculun, (2)Group B: lateral patel a retinaculun plus tibial tubercle anteromedial transfer. Clinical function and radiographic imaging of knee were used to evaluate the efficacy during the fol ow-up. Results 31 patients were fol owed up. According to HSS, clinical function of knee after arthroscopic surgery in both groups had improved significantly, compared to that before surgery(P<0.05). Radiological results had also improved(P<0.05). After surgery, QA in Group B were lower, LPA was higher than those in Group A(P0.05). Al surgical incisions recovered with classⅠhealing. Conclusion Knee arthroscopic surgery is a reliable treatment method for patel ofemoral malalignment, with more favorable results for lateral patel a retinaculun plus tibial tubercle anteromedial transfer.