Xu Caiqi, Zhao Jinzhong, Xie Guoming
Department of Orthopaedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Sports Medicine, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2016 Apr 26;4:21-26. doi: 10.1016/j.asmart.2016.03.001. eCollection 2016 Apr.
Medial patella-femoral ligament reconstruction (MPFLR) using hamstring tendon is the main procedure for recurrent patellar instability. The anterior half of the peroneus longus tendon (AHPLT) has been proven to be a useful alternate to the hamstring tendon in knee ligament reconstruction. The purpose of this study was to evaluate the clinical outcome of MPFLR using the new graft.
Forty-five patients with recurrent patellar instability received MPFLR using the AHPLT. Tibial tubercle transfer and lateral release were also performed. Follow-ups were performed at 12 months and 24 months postoperatively, and computed tomography was performed immediately following the operation and at follow-up. The passive patella glide test was performed prior to surgery, during the operation, and at each follow-up point. Knee function was evaluated preoperatively and postoperatively using the International Knee Documentation Committee, Lysholm, Kujala, and Tegner rating scales.
Forty patients were followed for 2 years and received complete serial computed tomography examinations and functional evaluations. The correction of the static patellar position remained through the follow-ups. Functional evaluations at 2 years revealed statistical significant improvement over preoperative status, with International Knee Documentation Committee subjective score, Lysholm score, Kujala score, and Tegner score.
AHPLT is a promising alternative graft for MPFLR, together with lateral release and tibial tubercle transfer, satisfactory static patellar position, and functional outcomes have been achieved in the treatment of recurrent patellar dislocation in adults.
Level IV, case series.
采用腘绳肌腱进行内侧髌股韧带重建（MPFLR）是复发性髌骨不稳定的主要手术方法。已证实腓骨长肌腱前半部分（AHPLT）在膝关节韧带重建中是腘绳肌腱的一种有用替代物。本研究的目的是评估使用新移植物进行MPFLR的临床结果。
45例复发性髌骨不稳定患者接受了使用AHPLT的MPFLR。还进行了胫骨结节移位和外侧松解术。术后12个月和24个月进行随访，并在术后即刻和随访时进行计算机断层扫描。在手术前、手术期间和每个随访点进行被动髌骨滑动试验。术前和术后使用国际膝关节文献委员会、Lysholm、Kujala和Tegner评分量表评估膝关节功能。
40例患者随访2年，接受了完整的系列计算机断层扫描检查和功能评估。静态髌骨位置的矫正在随访期间一直保持。2年时的功能评估显示，与术前状态相比有统计学显著改善，包括国际膝关节文献委员会主观评分、Lysholm评分、Kujala评分和Tegner评分。
AHPLT是MPFLR一种有前景的替代移植物，结合外侧松解和胫骨结节移位，在治疗成人复发性髌骨脱位中取得了满意的静态髌骨位置和功能结果。
IV级，病例系列。
