Department of Joint Surgery, Orthopedic Research Institute of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.
Department of the General Practice, Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.
Knee Surg Sports Traumatol Arthrosc. 2020 Mar;28(3):995-1001. doi: 10.1007/s00167-019-05620-1. Epub 2019 Jul 16.
The purpose of this study was to evaluate and compare the clinical outcomes of two different fixation techniques for anatomic medial patellofemoral ligament (MPFL) reconstruction.
A retrospective study was undertaken between 2012 and 2018 of 60 cases of patellar dislocation who underwent surgical reconstruction between 2007 and 2010: 30 patients were treated with modified semi-tunnel bone bridge fixation (group A) and 30 patients with suture anchor fixation (group B). All patients had computed tomography scans available to review the patellar tilt angle and lateral patellar angle (LPA). In addition, a physical examination was performed, and the patellar apprehension sign and patellar stability were evaluated. Knee function was also evaluated using the Kujala score and Lysholm score.
At a minimum 5-year follow-up, the patellar tilt angle and LPA were restored to the normal range, and a significant difference was observed between the groups. There was a significant improvement in knee function in the Kujala and Lysholm scores after surgery in both groups. At the final follow-up, the mean Kujala and Lysholm scores in groups A and B were significantly different.
Both the semi-tunnel bone bridge and suture anchor fixation for double-bundle anatomic reconstruction of the MPFL can effectively restore patellar stability and improve knee function. The semi-tunnel bone bridge technique achieved statistically better knee function than the suture anchor technique at a minimum 5-year follow-up.
III.
本研究旨在评估和比较两种不同固定技术在解剖内侧髌股韧带（MPFL）重建中的临床效果。
回顾性研究了 2007 年至 2010 年间接受手术重建的 60 例髌骨脱位患者，其中 30 例采用改良半隧道骨桥固定（A 组），30 例采用缝线锚钉固定（B 组）。所有患者均有 CT 扫描可供评估髌骨倾斜角和外侧髌骨角（LPA）。此外，还进行了体格检查，评估髌腱退缩征和髌骨稳定性。采用 Kujala 评分和 Lysholm 评分评估膝关节功能。
至少 5 年随访时，髌骨倾斜角和 LPA 恢复至正常范围，两组间差异有统计学意义。两组患者术后膝关节功能 Kujala 和 Lysholm 评分均显著改善。末次随访时，A、B 两组的平均 Kujala 和 Lysholm 评分差异有统计学意义。
双束解剖重建 MPFL 的半隧道骨桥和缝线锚钉固定均能有效恢复髌骨稳定性，改善膝关节功能。至少 5 年随访时，半隧道骨桥技术在膝关节功能方面优于缝线锚钉技术。
III 级。
