Zhang Hangzhou, Ye Mao, Liang Qingwei
Department of Orthopedics, Joint Surgery, and Sports Medicine, First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China.
Orthop J Sports Med. 2020 Feb 10;8(2):2325967119900373. doi: 10.1177/2325967119900373. eCollection 2020 Feb.
Several fixation methods have been introduced in medial patellofemoral ligament (MPFL) reconstruction. However, the optimal management of patients with recurrent patellar dislocation remains controversial.
To present a case series with a minimum 2-year follow-up of 29 patients with recurrent patellar dislocation who underwent a new transosseous suture fixation technique for MPFL reconstruction.
Case series; Level of evidence, 4.
From January 2014 through February 2016, a total of 29 patients with recurrent patellar dislocation for which the MPFL was reconstructed with transosseous suture patellar fixation were studied. All patients were available for follow-up (mean, 37.52 months; range, 26-48 months). The patellar attachment was fixed by transosseous patellar sutures. The International Knee Documentation Committee (IKDC) subjective knee score, Kujala score, Tegner score, range of motion, congruence angle, patellar tilt angle, and complications were assessed both pre- and postoperatively.
No recurrent dislocation was observed in any of the 29 patients for a minimum of 2 years. All outcome scores improved significantly from preoperatively to postoperatively: the average IKDC subjective knee evaluation score from 53 to 87, Kujala from 54 to 90, Lysholm from 50 to 89, and Tegner from 3 to 5 ( < .001 for all). The congruence angle significantly decreased from 22° preoperatively to -3° postoperatively, and the patellar tilt angle (Merchant) decreased from 23° preoperatively to 5° postoperatively ( < .001 for both). In total, 25 patients (25/29; 86.21%) were completely pain-free when performing activities of daily living at the last follow-up, and 27 patients (93.1%) rated themselves as very satisfied or satisfied with the results.
In patients with chronic recurrent patellar dislocation, transosseous patellar suture fixation for MPFL reconstruction can significantly improve patellar stability and achieve good results at short-term follow-up.
内侧髌股韧带（MPFL）重建已引入多种固定方法。然而，复发性髌骨脱位患者的最佳治疗方案仍存在争议。
介绍一组对29例复发性髌骨脱位患者进行新的经骨缝合法固定技术重建MPFL并至少随访2年的病例系列。
病例系列；证据等级，4级。
2014年1月至2016年2月，共研究了29例采用经骨缝合法髌骨固定重建MPFL的复发性髌骨脱位患者。所有患者均获得随访（平均37.52个月；范围26 - 48个月）。通过经骨髌骨缝线固定髌骨附着点。术前和术后均评估国际膝关节文献委员会（IKDC）主观膝关节评分、库亚拉评分、特格纳评分、活动范围、适合角、髌骨倾斜角及并发症。
29例患者中至少2年未观察到复发性脱位。所有结果评分从术前到术后均显著改善：IKDC主观膝关节评估平均评分从53分提高到87分，库亚拉评分从54分提高到90分， Lysholm评分从50分提高到89分，特格纳评分从3分提高到5分（所有P均<0.001）。适合角从术前的22°显著降至术后的 - 3°，髌骨倾斜角（Merchant法）从术前的23°降至术后的5°（两者P均<0.001）。末次随访时，共有25例患者（25/29；86.21%）在进行日常生活活动时完全无疼痛，27例患者（93.1%）对结果评价为非常满意或满意。
对于慢性复发性髌骨脱位患者，经骨髌骨缝线固定重建MPFL可显著提高髌骨稳定性，在短期随访中取得良好效果。
