Ostermeier Sven, Stukenborg-Colsman Christina, Wirth Carl-Joachim, Bohnsack Michael
Orthopädische Klinik, Medizinische Hochschule Hannover (MHH), Anna-von-Borries-Strasse 1-7, D-30625, Hannover, Germany.
Oper Orthop Traumatol. 2007 Dec;19(5-6):489-501. doi: 10.1007/s00064-007-1022-0.
Stabilization of the patella by reconstruction of the medial patellofemoral ligament.
Chronic recurrent lateral dislocation or subluxation of the patella. Habitual lateral dislocation of the patella.
Primary dislocation of the patella. Genu valgum with a Q-angle > 15 degrees . Status following semitendinosus tendon transfer to reconstruct the anterior cruciate ligament. Joint infection. Neurogenic instability, ischiocrural muscle deficiency.
Division of the distal insertion of the semitendinosus muscle at the pes anserinus. Subligamentous tunneling at the proximal insertion of the medial collateral ligament. The distal end of the semitendinosus tendon is transferred through the subligamentous tunnel to the medial patellar margin. Fixation of the tendon to the medioproximal patellar margin by passing it through an oblique transpatellar drill hole.
The patella was stabilized by dynamic reconstruction of the medial patellofemoral ligament in 14 patients with chronic recurrent or habitual lateral patellar dislocation. Ten patients were available for clinical follow-up assessment at an average of 13 months (8-27 months) postoperatively. The postoperative Kujala Index (maximum 100 points) increased on average from 56 to 95 points.
通过重建髌股内侧韧带稳定髌骨。
髌骨慢性复发性外侧脱位或半脱位。习惯性髌骨外侧脱位。
髌骨初次脱位。Q角>15度的膝外翻。半腱肌肌腱转移重建前交叉韧带后的状态。关节感染。神经源性不稳定，坐骨神经肌肉功能不全。
在鹅足处切断半腱肌的远侧附着点。在内侧副韧带近侧附着点进行韧带下隧道钻孔。将半腱肌肌腱的远端通过韧带下隧道转移至髌骨内侧边缘。通过斜行穿过髌骨的钻孔将肌腱固定于髌骨近内侧边缘。
14例慢性复发性或习惯性髌骨外侧脱位患者通过髌股内侧韧带动态重建实现了髌骨稳定。10例患者术后平均13个月（8 - 27个月）接受临床随访评估。术后库贾拉指数（满分100分）平均从56分提高到95分。
