Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.
Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.
Sci Rep. 2017 Jan 25;7:41360. doi: 10.1038/srep41360.
We aimed to assess the CT-based bony tunnel valuations and their correlation with knee function after patellar dislocation triple surgeries. A retrospective study was performed on 66 patients (70 knees) who underwent patellar dislocation triple surgeries. The surgery was MPFL reconstruction primarily, combined with lateral retinaculum release and tibial tubercle osteotomy. CT examinations were performed to determine the femoral tunnel position, along with the patellar and femoral tunnel width 3 days and more than 1 year after operation for follow-up. Functional evaluation based on Kujala and Lysholm scores was also implemented. We compared tunnel width of the first and last examinations and correlated femoral tunnel position of the last examination with knee function. At the last follow-up, femoral tunnel position in the anterior-posterior direction was moderately correlated with knee function. Femoral tunnel position in the proximal-distal direction was not associated with postoperative knee function. Patellar and femoral tunnel width increased significantly at the last follow-up. However, no significant functional difference was found between patients with and without femoral tunnel enlargement. Our results suggested that the tunnel malposition in anterior-posterior position based on CT was related to impaired knee function during the follow-ups.
我们旨在评估髌脱位三联术后 CT 评估的骨性隧道及其与膝关节功能的相关性。对 66 例（70 膝）接受髌脱位三联术的患者进行回顾性研究。手术主要是 MPFL 重建，同时行外侧支持带松解和胫骨结节截骨术。术后 3 天和 1 年以上进行 CT 检查，以确定股骨隧道位置以及髌股和股骨隧道的宽度。还进行了基于 Kujala 和 Lysholm 评分的功能评估。我们比较了第一次和最后一次检查的隧道宽度，并将最后一次检查的股骨隧道位置与膝关节功能相关联。在最后一次随访时，股骨隧道在前-后方向上的位置与膝关节功能中度相关。股骨隧道在近-远方向上的位置与术后膝关节功能无关。最后一次随访时，髌股和股骨隧道的宽度明显增加。然而，在股骨隧道扩大的患者和无股骨隧道扩大的患者之间，没有发现功能差异。我们的结果表明，基于 CT 的前-后位置的隧道错位与随访期间膝关节功能受损有关。
