Clinical Outcomes of Medial Patellofemoral Ligament Reconstruction Using Semitendinosus Autograft for Recurrent Patellar Dislocation

Sheng-Hsun Lee, Shih-Sheng Chang, I.-Jung Chen, Chun-Ying Cheng, C. Chiu, Min-Chain Tsai, K. Hsu, Y. Chan
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引用次数: 1

Abstract

Background: Recurrent patellar dislocation is a rare but complex issue. Medial patellar stabilizer insufficiency, particularly with the medial patellofemoral ligament (MPFL), is commonly present in these patients. There are several surgical methods to address this problem. Purpose: To evaluate the clinical outcome of MPFL reconstruction when using a semitendinosus autograft and a novel tendon fixation technique to treat recurrent patellar dislocation. Methods: Twelve consecutive patients (5 males, 7 females) who failed in conservative treatment were enrolled into this prospective study. They were treated with MPFL reconstruction using a semitendinosus autograft. The mean follow-up time was 16.7 months (range, 14-22 months). Preoperative and postoperative radiographic parameters, functional scores (e.g., Lysholm knee scoring scale and Kujala scale), and postoperative complications were evaluated. Results: Eleven of twelve patients (91.7%) had good-to-excellent outcomes. There were statistically significant improvements in the Lysholm knee scoring scale (p<0.001) and Kujala scale (p<0.001). Additionally, the postoperative tilt angle improved significantly (p<0.001). Conclusions: Using a semitendinosus autograft with Bioscrew fixation and an additional pull-out suture during MPLF reconstruction is a safe and effective method for treating recurrent patellar dislocation in selective patients.
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自体半腱肌重建髌股内侧韧带治疗复发性髌骨脱位的临床效果
背景:复发性髌骨脱位是一种罕见但复杂的疾病。内侧髌骨稳定器功能不全,特别是内侧髌股韧带(MPFL),通常存在于这些患者中。有几种手术方法可以解决这个问题。目的:评价采用自体半腱肌腱和新型肌腱固定技术治疗复发性髌骨脱位的临床效果。方法:连续12例保守治疗失败的患者(男5例,女7例)纳入前瞻性研究。他们采用半腱肌腱自体移植物重建MPFL。平均随访时间16.7个月(14 ~ 22个月)。评估术前和术后影像学参数、功能评分(如Lysholm膝关节评分和Kujala评分)和术后并发症。结果:12例患者中有11例(91.7%)预后良好。Lysholm膝关节评分量表(p<0.001)和Kujala评分量表(p<0.001)的改善有统计学意义。此外,术后倾斜角度明显改善(p<0.001)。结论:在MPLF重建过程中,采用生物螺钉固定的自体半腱肌腱和额外的拔出缝线是治疗复发性髌骨脱位的一种安全有效的方法。
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