Hiroshima University, Department of Physical Therapy and Occupational Therapy Sciences, Japan.
Am J Sports Med. 2011 Jan;39(1):140-5. doi: 10.1177/0363546510377436. Epub 2010 Oct 7.
The medial patellofemoral ligament (MPFL) is the most important factor for stabilizing the patella and preventing lateral patellar dislocation. Medial patellofemoral ligament reconstruction is an accepted surgical technique to restore patellofemoral stability after lateral patellar dislocation. The authors recently developed a new anatomical MPFL reconstruction method using a cylindrical bone plug and grafted semitendinosus tendon at the anatomical femoral attachment site to mimic the native MPFL. This study evaluated the new technique for stabilizing recurrent patellar dislocation.
This new MPFL reconstruction technique will improve knee symptoms and function with excellent clinical results.
Case series; Level of evidence, 4.
Thirty-one knees were evaluated from 29 cases of recurrent patellar dislocation that were surgically treated using the anatomical MPFL reconstruction technique. The average patient age was 22.2 years (range, 12-34 years); postsurgery follow-up was 2 to 5 years (average, 3.2 years). The patients were clinically evaluated based on the Kujala score, range of motion, and signs of apprehension. The Merchant view was used to measure congruence and tilting angles.
Of the 31 knees, 30 showed good clinical results after surgery, while 1 patient showed remaining signs of apprehension. The Kujala score improved from an average of 64 points (range, 35-70) initially to an average of 94.5 points (range, 79-100) at the final follow-up. Range of motion improved for all patients, with an average knee extension of 0° ± 2° and knee flexion of 145° ± 3° at final follow-up. No patellar redislocation was reported. Radiological assessment indicated significant improvement to the congruence angle from 13° ± 4° before surgery to -5° ± 5° at the final follow-up, while the tilting angle went from 8° ± 7° before surgery to 7° ± 4° at the final follow-up.
This study demonstrated excellent results using the new procedure for recurrent dislocation of the patella, with instability in only 1 of 31 knees (3.2%).
内侧髌股韧带（MPFL）是稳定髌骨和防止髌骨外侧脱位最重要的因素。内侧髌股韧带重建是一种公认的手术技术，用于在髌骨外侧脱位后恢复髌股稳定性。作者最近开发了一种新的解剖学 MPFL 重建方法，使用圆柱形骨栓和移植物半腱肌在解剖学股骨附着部位，以模拟天然 MPFL。本研究评估了新的技术在复发性髌骨脱位中的稳定性。
这种新的 MPFL 重建技术将改善膝关节症状和功能，具有良好的临床效果。
病例系列；证据水平，4 级。
从 29 例复发性髌骨脱位的病例中评估了 31 个膝关节，这些病例均采用解剖学 MPFL 重建技术进行手术治疗。平均患者年龄为 22.2 岁（范围 12-34 岁）；术后随访 2 至 5 年（平均 3.2 年）。根据 Kujala 评分、运动范围和恐惧征对患者进行临床评估。使用 Merchant 视图测量髌骨的吻合和倾斜角度。
31 个膝关节中，30 个膝关节在手术后显示出良好的临床效果，而 1 个患者仍有恐惧征。Kujala 评分从最初的平均 64 分（范围 35-70）提高到最终随访时的平均 94.5 分（范围 79-100）。所有患者的运动范围均得到改善，最终随访时的平均膝关节伸展为 0°±2°，膝关节屈曲为 145°±3°。没有髌骨再脱位的报告。放射学评估表明，髌骨吻合角从术前的 13°±4°显著改善到最终随访时的-5°±5°，而倾斜角从术前的 8°±7°改善到最终随访时的 7°±4°。
本研究显示，对于复发性髌骨脱位，新手术方法效果极佳，31 个膝关节中仅有 1 个（3.2%）不稳定。
