Hiemstra Laurie A, Frizzell Bevan, Kerslake Sarah
Banff Sport Medicine, Banff, Alberta, Canada (Dr. Hiemstra and Ms. Kerslake); the Department of Surgery (Dr. Hiemstra) and Department of Radiology (Mr. Frizzell), University of Calgary, Calgary, Alberta, Canada.
J Am Acad Orthop Surg Glob Res Rev. 2017 Mar 31;1(1):e001. doi: 10.5435/JAAOSGlobal-D-17-00001. eCollection 2017 Mar.
The medial quadriceps tendon femoral ligament (MQTFL) reconstruction is an alternative to the patellar bony fixation of the medial patellofemoral ligament reconstruction for the treatment of lateral patellofemoral dislocation. We describe the first report of a unique application of this technique in a patient with a previous patellectomy to treat a dislocating quadriceps tendon. An active 59-year-old Caucasian man presented 25 years after patellectomy with a dislocating quadriceps tendon and significant dysfunction. Stabilization of the knee extensor mechanism with an MQTFL reconstruction and retensioning of the quadriceps complex by tibial tubercle distalization provided stability and improved function. Extensor tendon instability is a rare complication after patellectomy that can cause significant pain and dysfunction. Successful stabilization of the quadriceps mechanism through an MQTFL reconstruction can provide excellent patient satisfaction and functional results. This technique may have implications for patellofemoral instability surgeries and in cases of knee extensor dysfunction after total knee arthroplasty.
股四头肌内侧肌腱股骨韧带（MQTFL）重建术是治疗髌股外侧脱位时，用于替代内侧髌股韧带重建术髌骨骨性固定的一种方法。我们报道了该技术在一名既往行髌骨切除术患者中独特应用的首例报告，该患者因股四头肌肌腱脱位前来就诊。一名59岁的活跃白人男性，在髌骨切除术后25年出现股四头肌肌腱脱位及明显功能障碍。通过MQTFL重建稳定膝关节伸肌机制，并通过胫骨结节远移对股四头肌复合体进行重新张紧，提供了稳定性并改善了功能。伸肌腱不稳定是髌骨切除术后一种罕见的并发症，可导致严重疼痛和功能障碍。通过MQTFL重建成功稳定股四头肌机制可使患者满意度和功能结果极佳。该技术可能对髌股不稳定手术以及全膝关节置换术后膝关节伸肌功能障碍的病例具有重要意义。
