Division of Sports Medicine, Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, Kuwait City, Kuwait.
Department of Physical Medicine, Al-Razi Orthopaedic Hospital, Kuwait City, Kuwait.
J Knee Surg. 2020 Oct;33(10):998-1003. doi: 10.1055/s-0039-1688841. Epub 2019 May 23.
Acute traumatic patellar dislocation is a common injury, and spontaneous reduction may occur at the time of injury or may be reduced at the field of the accident by someone. It may be associated with osteochondral fractures and rupture of medial patellar stabilizers leading to recurrent patellar instability. The aim of this prospective study was to evaluate the outcomes of medial patellofemoral (PF) ligament (MPFL) reconstruction in recurrent traumatic patellar dislocation. Forty-five patients presented with PF instability as a result of traumatic rupture MPFL with normal patellar tracking underwent MPFL reconstruction without patellar fixation hardware through two parallel transpatellar tunnels and one screw in femoral tunnel. All patients were evaluated clinically preoperatively and at a minimum follow-up of 24 months, and International Knee Documentation Committee (IKDC) and Kujala scores were used to assess the clinical results. All patients were available for evaluation at a minimum of 24 months (up to 36 months). The mean age of these patients at the time of surgery was 22.82 years (range: 18-34 years). All patients gave history of trauma of their knees. Mean IKDC scale showed significant improvement as it rose from 47.17 preoperatively to 77.94 postoperatively, and mean Kujala score rose from 53.88 preoperatively to 86.24 postoperatively ( < 0.001). No recurrence of dislocation was recorded. Only three patients had mild atrophy of thigh and one patient had some difficulty in jumping. Reconstruction of MPFL by this method provides good clinical result in the treatment of PF instability by using autologous graft (semitendinosus and gracilis). Less hardware were used with less complications.
急性创伤性髌骨脱位是一种常见的损伤,受伤时可能会自行复位,也可能在事故现场由他人复位。它可能伴有骨软骨骨折和内侧髌骨稳定器的破裂,导致复发性髌骨不稳定。本前瞻性研究旨在评估复发性创伤性髌骨脱位患者行内侧髌股(PF)韧带(MPFL)重建的疗效。45 例患者因 MPFL 创伤性撕裂导致 PF 不稳定,髌骨轨迹正常,采用平行双经髌骨隧道和股骨隧道单螺钉的 MPFL 重建技术,不使用髌骨固定硬件。所有患者均在术前和至少 24 个月的随访时进行临床评估,采用国际膝关节文献委员会(IKDC)和 Kujala 评分评估临床结果。所有患者均在至少 24 个月(最长 36 个月)时进行了评估。这些患者的平均手术年龄为 22.82 岁(18-34 岁)。所有患者均有膝关节创伤史。平均 IKDC 评分显著提高,由术前的 47.17 分提高到术后的 77.94 分,平均 Kujala 评分由术前的 53.88 分提高到术后的 86.24 分( < 0.001)。未记录到脱位复发。仅有 3 例患者大腿轻度萎缩,1 例患者跳跃有些困难。使用自体移植物(半腱肌和股薄肌)重建 MPFL 可提供良好的临床疗效,治疗 PF 不稳定。使用较少的硬件,并发症也较少。