Background The medial patellofemoral ligament （MPFL） reconstruction is popular in clinical practice for chronic patellar dislocation; however, the combination with vastus medialis advancement is rare. The aim of thi...Background The medial patellofemoral ligament （MPFL） reconstruction is popular in clinical practice for chronic patellar dislocation; however, the combination with vastus medialis advancement is rare. The aim of this study was to evaluate the clinical outcome of the combination of MPFL reconstruction with vastus medialis advancement.Methods We retrospectively analyzed 69 patients with chronic patellar dislocation between July 2004 and October 2008： twenty eight cases with isolated MPFL reconstruction （group Ⅰ）, forty one cases with the combination of MPFL reconstruction with vastus medialis advancement （group C）. All patients had CT scans available for review with knee flexion at 30 degree, on which the congruence angle, patellar tilt angle and patellar lateral shift were measured. Physical apprehension tests were examined and the redislocation was recorded. In addition, knee function was evaluated using the Kujala score and subjective questionnaires.Results Patients were followed up for a mean of 42 months （12-65 months） without a recurrent dislocation reported.Postoperatively, all indexes on CT scan were within the normal range without a statistical difference between the two groups. Results from the apprehension test showed eight patients in group Ⅰ and three in group Chad patellar lateral shift exceeding 1.5 cm with a hard end point （P 〈0.05）. The Kujala score improved significantly from 51.3±4.5 to 79.9±6.2 in group Ⅰ and from 53.7±5.2 to 83.9±6.5 in group C （P 〉0.05）. However, the subjective questionnaire revealed a significant difference （P 〈0.05）, including 12 excellent, seven good and nine fair in group Ⅰ and 30 excellent, six good and five fair in group C.Conclusion The combination of MPFL reconstruction with vastus medialis advancement is better than isolated reconstruction to improve the subjective effects and decrease the patellar instability rate for chronic patellar dislocation.展开更多
Background Medial patellofemoral ligament （MPFL） reconstruction is the preferred operative treatment for recurrent patellar dislocation. The purpose of this study was to report a novel suture-tie technique of patell...Background Medial patellofemoral ligament （MPFL） reconstruction is the preferred operative treatment for recurrent patellar dislocation. The purpose of this study was to report a novel suture-tie technique of patellar side fixation in medial patellofemoral ligament reconstruction for recurrent patellar dislocation, and to evaluate the intermediate-term results. Methods We retrospectively reviewed the results of 22 MPFL reconstructions in 21 patients （6 male and 15 female） with a suture-tie technique performed by a single surgeon between March 2004 and July 2009. All patients had been diagnosed with recurrent patellar dislocation. Outcomes were assessed preoperatively and postoperatively by physical and radiographic examination as well as with Kujala and Lysholm scores. Results At the mean follow-up month 37.5 （range： 24-56 months）, there was no graft failure. Primary healing was achieved in all cases. At the final follow-up, the mean Kujala score improved from 53.9 （range： 46-62 points） to 84.1 （range： 78-90 points） postoperatively （P 〈0.05）, and the mean Lysholm score improved from 47.2 points （range： 37-57 points） to 82.8 points （range： 76-89 points） postoperatively （P 〈0.05）. To date, no patients have reported redislocation or subluxation; however, there is one patient with a positive apprehension test. Conclusion A suture-tie technique in medial patellofemoral ligament reconstruction can restore patella stability without significant complication.展开更多
Purpose:The medial patellofemoral ligament(MPFL)acts as primary restraint to lateral patellar dislocation and its rupture has been reported in almost all cases of acute patellar dislocation.Various surgical techniques...Purpose:The medial patellofemoral ligament(MPFL)acts as primary restraint to lateral patellar dislocation and its rupture has been reported in almost all cases of acute patellar dislocation.Various surgical techniques have been described for MPFL reconstruction,using many femoral and patellar fixation techniques and different grafts.This article details our technique for MPFL reconstruction using semitendinosus graft which avoids the use of implant at patellar end.Methods:Twenty patients(8 males and 12 females)with complaints regarding acute and chronic lateral patellar instability were evaluated and treated by MPFL reconstruction procedure.The mean age of patients was 21 years(range 17-34 years).MPFL reconstruction was performed using semitendinosus graft passing through two parallel,obliquely directed tunnels created in patella.Fixation of graft was done with an interference screw only at the femoral end.Mean follow-up period after intervention was 26.4 months(range 23-30 months).Results were evaluated using Kujala score.Results:All patients gained adequate patellar stability and full arc of motion.No incidence of patella fracture was noted.There were no postoperative complications related to the procedure.There was no recurrence of instability in patella at final follow-up.Conclusion:Passing the graft through the tunnels in patella without use of any implant has given excellent functional outcome and moreover has the advantages of less implant-related complications and cost-effectiveness.展开更多
目的观察微创内侧髌股韧带重建与开放手术下带线锚钉治疗急性创伤性髌骨脱位的疗效。方法选取甘肃省庆阳市人民医院2018年1月至2021年1月收治的98例急性创伤性髌骨脱位患者作为研究对象,通过数字表法随机将患者分为观察组和对照组,各49...目的观察微创内侧髌股韧带重建与开放手术下带线锚钉治疗急性创伤性髌骨脱位的疗效。方法选取甘肃省庆阳市人民医院2018年1月至2021年1月收治的98例急性创伤性髌骨脱位患者作为研究对象,通过数字表法随机将患者分为观察组和对照组,各49例。观察组给予微创内侧髌股韧带重建术治疗,对照组给予开放手术下带线锚钉治疗,对比2组患者手术前和手术7 d髌骨外侧角、髌骨适合角、髌骨外侧移动度、膝关节Lysholm评分、美国特种外科医院膝关节评分(hospital for special surgery,HSS);对比2组患者住院期间不良反应发生率。结果术后6个月,2组患者髌骨外侧角均升高,髌骨适合角和髌骨外侧移动度均降低,且相较于对照组,观察组髌骨外侧角更高,髌骨适合角和髌骨外侧移动度更低,差异有统计学意义(P<0.05);术后6个月,2组患者Lysholm评分均升高,且相较于对照组,观察组Lysholm评分更高,差异有统计学意义(P<0.05);术后6个月,2组患者HSS评分均升高,且相较于对照组,观察组HSS评分更高,差异有统计学意义(P<0.05);对照组不良反应发生率[14.28%(7/49)]高于观察组[2.04%(1/49)],差异有统计学意义(P<0.05)。结论与开放手术下带线锚钉手术相比较,微创内侧髌股韧带重建对急性创伤性膑骨脱位患者运动轨迹以及膝关节功能的改善更为明显,且并发症发生率也更低。展开更多
文摘Background The medial patellofemoral ligament （MPFL） reconstruction is popular in clinical practice for chronic patellar dislocation; however, the combination with vastus medialis advancement is rare. The aim of this study was to evaluate the clinical outcome of the combination of MPFL reconstruction with vastus medialis advancement.Methods We retrospectively analyzed 69 patients with chronic patellar dislocation between July 2004 and October 2008： twenty eight cases with isolated MPFL reconstruction （group Ⅰ）, forty one cases with the combination of MPFL reconstruction with vastus medialis advancement （group C）. All patients had CT scans available for review with knee flexion at 30 degree, on which the congruence angle, patellar tilt angle and patellar lateral shift were measured. Physical apprehension tests were examined and the redislocation was recorded. In addition, knee function was evaluated using the Kujala score and subjective questionnaires.Results Patients were followed up for a mean of 42 months （12-65 months） without a recurrent dislocation reported.Postoperatively, all indexes on CT scan were within the normal range without a statistical difference between the two groups. Results from the apprehension test showed eight patients in group Ⅰ and three in group Chad patellar lateral shift exceeding 1.5 cm with a hard end point （P 〈0.05）. The Kujala score improved significantly from 51.3±4.5 to 79.9±6.2 in group Ⅰ and from 53.7±5.2 to 83.9±6.5 in group C （P 〉0.05）. However, the subjective questionnaire revealed a significant difference （P 〈0.05）, including 12 excellent, seven good and nine fair in group Ⅰ and 30 excellent, six good and five fair in group C.Conclusion The combination of MPFL reconstruction with vastus medialis advancement is better than isolated reconstruction to improve the subjective effects and decrease the patellar instability rate for chronic patellar dislocation.
文摘Background Medial patellofemoral ligament （MPFL） reconstruction is the preferred operative treatment for recurrent patellar dislocation. The purpose of this study was to report a novel suture-tie technique of patellar side fixation in medial patellofemoral ligament reconstruction for recurrent patellar dislocation, and to evaluate the intermediate-term results. Methods We retrospectively reviewed the results of 22 MPFL reconstructions in 21 patients （6 male and 15 female） with a suture-tie technique performed by a single surgeon between March 2004 and July 2009. All patients had been diagnosed with recurrent patellar dislocation. Outcomes were assessed preoperatively and postoperatively by physical and radiographic examination as well as with Kujala and Lysholm scores. Results At the mean follow-up month 37.5 （range： 24-56 months）, there was no graft failure. Primary healing was achieved in all cases. At the final follow-up, the mean Kujala score improved from 53.9 （range： 46-62 points） to 84.1 （range： 78-90 points） postoperatively （P 〈0.05）, and the mean Lysholm score improved from 47.2 points （range： 37-57 points） to 82.8 points （range： 76-89 points） postoperatively （P 〈0.05）. To date, no patients have reported redislocation or subluxation; however, there is one patient with a positive apprehension test. Conclusion A suture-tie technique in medial patellofemoral ligament reconstruction can restore patella stability without significant complication.
文摘Purpose:The medial patellofemoral ligament(MPFL)acts as primary restraint to lateral patellar dislocation and its rupture has been reported in almost all cases of acute patellar dislocation.Various surgical techniques have been described for MPFL reconstruction,using many femoral and patellar fixation techniques and different grafts.This article details our technique for MPFL reconstruction using semitendinosus graft which avoids the use of implant at patellar end.Methods:Twenty patients(8 males and 12 females)with complaints regarding acute and chronic lateral patellar instability were evaluated and treated by MPFL reconstruction procedure.The mean age of patients was 21 years(range 17-34 years).MPFL reconstruction was performed using semitendinosus graft passing through two parallel,obliquely directed tunnels created in patella.Fixation of graft was done with an interference screw only at the femoral end.Mean follow-up period after intervention was 26.4 months(range 23-30 months).Results were evaluated using Kujala score.Results:All patients gained adequate patellar stability and full arc of motion.No incidence of patella fracture was noted.There were no postoperative complications related to the procedure.There was no recurrence of instability in patella at final follow-up.Conclusion:Passing the graft through the tunnels in patella without use of any implant has given excellent functional outcome and moreover has the advantages of less implant-related complications and cost-effectiveness.
文摘目的观察微创内侧髌股韧带重建与开放手术下带线锚钉治疗急性创伤性髌骨脱位的疗效。方法选取甘肃省庆阳市人民医院2018年1月至2021年1月收治的98例急性创伤性髌骨脱位患者作为研究对象,通过数字表法随机将患者分为观察组和对照组,各49例。观察组给予微创内侧髌股韧带重建术治疗,对照组给予开放手术下带线锚钉治疗,对比2组患者手术前和手术7 d髌骨外侧角、髌骨适合角、髌骨外侧移动度、膝关节Lysholm评分、美国特种外科医院膝关节评分(hospital for special surgery,HSS);对比2组患者住院期间不良反应发生率。结果术后6个月,2组患者髌骨外侧角均升高,髌骨适合角和髌骨外侧移动度均降低,且相较于对照组,观察组髌骨外侧角更高,髌骨适合角和髌骨外侧移动度更低,差异有统计学意义(P<0.05);术后6个月,2组患者Lysholm评分均升高,且相较于对照组,观察组Lysholm评分更高,差异有统计学意义(P<0.05);术后6个月,2组患者HSS评分均升高,且相较于对照组,观察组HSS评分更高,差异有统计学意义(P<0.05);对照组不良反应发生率[14.28%(7/49)]高于观察组[2.04%(1/49)],差异有统计学意义(P<0.05)。结论与开放手术下带线锚钉手术相比较,微创内侧髌股韧带重建对急性创伤性膑骨脱位患者运动轨迹以及膝关节功能的改善更为明显,且并发症发生率也更低。
