II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
DIBINEM, University of Bologna, via di Barbiano, 1/10, c/o Lab Biomeccanica ed Innovazione Tecnologica, 40136, Bologna, Italy.
Knee Surg Sports Traumatol Arthrosc. 2021 Apr;29(4):1191-1196. doi: 10.1007/s00167-020-06142-x. Epub 2020 Jul 10.
The aim of this study was to evaluate the efficacy of a new minimally invasive surgical technique for the reconstruction of the medial patellofemoral ligament (MPFL) with fascia lata allograft at 60-month minimum follow-up.
Nineteen consecutive patients with chronic recurrent patellar dislocation were treated with MPFL reconstruction (53% isolate procedure, 47% in combination with other treatments). Seventeen patients (11 males/6 females) were available at 60-month follow-up and were clinically evaluated with validated scores. New episodes of patellar dislocation were considered failures. Radiographic and CT scan evaluation were executed preoperatively and at 60-month follow-up.
All clinical scores improved from preoperative assessment to 24-month and 60-month follow-up (p < 0.001). Kujala score increased from 61.2 ± 18.1 to 86.7 ± 8.7 and 82.1 ± 10.2; KOOS increased from 54.5 ± 19 to 86.8 ± 9.6 and 84.3 ± 7.6; VAS for pain decreased from 5.1 ± 2.2 to 2.4 ± 1.5 and 1.7 ± 1.2; Tegner score increased from 3 [2-4] to 5 [3-8] and 5 [3-9], respectively. Objective IKDC improved too. No significant improvements between the 24-month and 60-month follow-up evaluations were recorded. Anterior knee pain was reported in two patients (12%). Treatment failure, a new episode of patellar dislocation 25 months after the surgery, was observed in one patient (6%). Radiographic OA changes were not statistically significant between preop and 60-month follow-up. Tuberosity-troclear groove (TT-TG) distance and the patellar tilt angle were subjected to significant changes due to MPFL reconstruction and associated procedures.
MPFL reconstruction with fascia lata allograft, alone or combined with other procedures, is a reliable treatment option for recurrent patellar dislocation with a success rate of 94% and without cartilage deterioration at 60-month follow-up.
IV.
本研究旨在评估使用阔筋膜移植物进行内侧髌股韧带（MPFL）重建的新微创技术的疗效，该技术的随访时间至少为 60 个月。
19 例慢性复发性髌骨脱位患者接受了 MPFL 重建（53%为单独手术，47%为联合其他治疗）。17 例患者（11 男/6 女）在 60 个月随访时进行了临床评估，并采用了经过验证的评分。将新出现的髌骨脱位视为失败。术前和 60 个月随访时进行了影像学和 CT 扫描评估。
所有临床评分均从术前评估提高到 24 个月和 60 个月随访（p<0.001）。Kujala 评分从 61.2±18.1 提高到 86.7±8.7 和 82.1±10.2；KOOS 从 54.5±19 提高到 86.8±9.6 和 84.3±7.6；疼痛 VAS 从 5.1±2.2 降低到 2.4±1.5 和 1.7±1.2；Tegner 评分从 3[2-4]提高到 5[3-8]和 5[3-9]。客观 IKDC 也有所改善。24 个月和 60 个月随访评估之间没有记录到显著改善。1 例患者（6%）在手术后 25 个月出现新的髌骨脱位，治疗失败。影像学 OA 变化在术前和 60 个月随访之间无统计学意义。由于 MPFL 重建和相关手术，滑车-髌股沟（TT-TG）距离和髌骨倾斜角发生了显著变化。
阔筋膜移植物单独或联合其他手术的 MPFL 重建是复发性髌骨脱位的可靠治疗选择，成功率为 94%，60 个月随访时无软骨恶化。
IV。
