Dhinsa Baljinder Singh, Bhamra Jagmeet Singh, James Chris, Dunnet William, Zahn Helmut
William Harvey Hospital, Kennington Road, Willesborough, Ashford, Kent, TN24 0LZ UK.
Knee. 2013 Dec;20(6):605-8. doi: 10.1016/j.knee.2013.05.013. Epub 2013 Aug 2.
The medial patellofemoral ligament (MPFL) acts as a soft tissue restraint to lateral subluxation of the patella, and is frequently damaged following patellar dislocation. A number of techniques for repair or reconstructions of the MPFL have been reported. We report two cases of patellar fracture following MPFL reconstruction utilizing suture anchors and bone tunnels that do not completely traverse the patella. The first case occurred seven months after surgery and the second case was at six weeks following surgery. There have been previous reports of patellar fracture following MPFL reconstruction, particularly when patellar tunnels completely traverse the patella. The authors decided to use suture anchors to reduce the risk of patellar fracture, and they feel that the fractures reported in this paper resulted from surgical error rather than system error. We feel that this is an important learning point when initially using this technique, and should be disseminated to other surgeons who undertake this surgery.
髌股内侧韧带(MPFL)作为防止髌骨向外侧半脱位的软组织约束结构,在髌骨脱位后常遭损伤。已有多种MPFL修复或重建技术的报道。我们报告两例采用缝线锚钉和未完全贯穿髌骨的骨隧道进行MPFL重建后发生髌骨骨折的病例。第一例发生在术后七个月,第二例发生在术后六周。此前已有MPFL重建后发生髌骨骨折的报道,尤其是当髌骨隧道完全贯穿髌骨时。作者决定使用缝线锚钉以降低髌骨骨折风险,他们认为本文报道的骨折是由手术失误而非系统失误导致的。我们认为这是初次使用该技术时的一个重要经验教训,应告知其他开展此类手术的外科医生。