Moran Thomas E, Burke John F, Diduch David R
Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, U.S.A.
Arthrosc Tech. 2020 Oct 2;9(10):e1613-e1617. doi: 10.1016/j.eats.2020.07.001. eCollection 2020 Oct.
Multiple techniques exist for patellar graft fixation during medial patellofemoral ligament (MPFL) reconstruction, each with their respective advantages and disadvantages. In recent studies, the use of 2 small (3.2-mm), short, oblique patellar tunnels with looped graft has been shown to be effective for patellar fixation during MPFL reconstruction. This technique does not appear to be associated with the same risk of patellar fracture as the use of larger (4.5-mm) transpatellar tunnels. A recent retrospective study also reported decreased risk of recurrent patellar instability and decreased cost compared with the use of suture anchors for patellar fixation, which is currently the most common modality. Given these promising findings relative to existing techniques for patellar fixation, further description of the senior author's technique for using these small (3.2-mm), short, oblique patellar tunnels is provided. This technique is safe, efficacious, and cost-conscious and should be considered a viable option for patellar fixation during MPFL reconstruction.
在髌股内侧韧带(MPFL)重建过程中,存在多种用于髌骨移植物固定的技术,每种技术都有其各自的优缺点。在最近的研究中,使用2个小的(3.2毫米)、短的、斜向的髌骨隧道并采用袢状移植物已被证明在MPFL重建过程中对髌骨固定有效。与使用较大的(4.5毫米)经髌骨隧道相比,该技术似乎不存在相同的髌骨骨折风险。最近一项回顾性研究还报告称,与目前最常用的使用缝线锚钉进行髌骨固定相比,复发性髌骨不稳定的风险降低,成本也降低。鉴于相对于现有髌骨固定技术的这些有前景的发现,本文进一步描述了资深作者使用这些小的(3.2毫米)、短的、斜向的髌骨隧道的技术。该技术安全、有效且注重成本,应被视为MPFL重建过程中髌骨固定的一个可行选择。