Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Orthopaedic Surgery, The Eighth People's Hospital of Hebei Province, Shijiazhuang, China.
Orthop Surg. 2021 May;13(3):847-854. doi: 10.1111/os.12945. Epub 2021 Mar 21.
To describe a surgical technique using suture tape for reconstruction of the medial patellofemoral ligament (MPFL). This technique restores the stability of the reconstructed ligament and has excellent postoperative outcomes.
This is a retrospective analysis. From January 2016 to June 2018, 17 patients underwent MPFL reconstruction using high-strength suture (FiberTape; Arthrex) augmentation, with at least 12 months of follow up. There were 11 female and 6 male patients. The mean age at the time of MPFL reconstruction was 22.1 years (range 13-34 years). Clinical outcomes included pain level, knee range of motion, passive patellar hypermobility, and maltracking at follow-up. The lateral patellofemoral angles, congruence angles, and patellar tilt angles were measured in a skyline view by CT at 30° of knee flexion at 12 months. Functional outcomes were assessed using the Lysholm knee scoring scale, the SF-12 score, the Tegner score, and the Crosby and Insall grading system at yearly follow-up.
No patients were lost at the last follow up. One patient had recurrence of patellar dislocation and none of the others had serious complications. The success rate of MPFL repair for preventing recurrent dislocations was 94.1% (16 of 17 knees). Fifteen knees had full range of motion of more than 130°. At follow-up, 2 knees were judged to have mild hypermobility and none had severe hypermobility or maltracking. Using the Crosby and Insall grading system, 12 knees (70.6%) were graded as excellent, 4 knees (23.5%) as good, 1 knee (5.9%) as fair to poor, and none as worse at the last follow-up assessment. In all patients, the Lysholm knee score (55.12 ± 13.52 vs 79.88 ± 7.50, P < 0.01), the SF-12 score (47 ± 9.53 vs 65.24 ± 12.82, P < 0.01), and the Tegner score (2.76 ± 1.39 vs 6.53 ± 1.70, P < 0.01) had improved at their 12-month follow up. Compared with preoperative radiological findings, there was a significant improvement in lateral patellofemoral angle (-10.24 ± 7.10 vs 6 ± 5.43, P < 0.01), patellar tilt angle (26.53 ± 7.23 vs 9.88 ± 4.24, P < 0.01), and congruence angle (29.59 ± 11.95 vs -8.65 ± 4.86, P < 0.01).
The use of FiberTape in MPFL reconstruction can improve the stability of the knee following surgery and has good midterm clinical results and low complication rates.
描述一种使用缝线带重建内侧髌股韧带（MPFL）的手术技术。该技术可恢复重建韧带的稳定性，并具有出色的术后效果。
这是一项回顾性分析。2016 年 1 月至 2018 年 6 月，17 名患者接受了高强度缝线（FiberTape；Arthrex）增强的 MPFL 重建，至少随访 12 个月。其中 11 名女性和 6 名男性，平均年龄为 22.1 岁（13-34 岁）。临床结果包括疼痛程度、膝关节活动度、被动髌骨过度活动和随访时的脱位。在 30°膝关节屈曲的侧位髌股角、吻合角和髌骨倾斜角在 CT 上测量，在 12 个月时进行。Lysholm 膝关节评分、SF-12 评分、Tegner 评分和 Crosby 和 Insall 分级系统在每年的随访中评估功能结果。
末次随访时无患者失访。1 例患者出现髌骨再脱位，无其他严重并发症。MPFL 修复防止再脱位的成功率为 94.1%（17 膝中的 16 膝）。15 膝的活动度超过 130°。随访时，2 膝被判断为轻度过度活动，无严重过度活动或脱位。根据 Crosby 和 Insall 分级系统，末次随访时 12 膝（70.6%）评为优秀，4 膝（23.5%）为良好，1 膝（5.9%）为可至差，无更差。在所有患者中，Lysholm 膝关节评分（55.12 ± 13.52 与 79.88 ± 7.50，P < 0.01）、SF-12 评分（47 ± 9.53 与 65.24 ± 12.82，P < 0.01）和 Tegner 评分（2.76 ± 1.39 与 6.53 ± 1.70，P < 0.01）在 12 个月时均有改善。与术前影像学比较，外侧髌股角（-10.24 ± 7.10 与 6 ± 5.43，P < 0.01）、髌骨倾斜角（26.53 ± 7.23 与 9.88 ± 4.24，P < 0.01）和吻合角（29.59 ± 11.95 与 -8.65 ± 4.86，P < 0.01）均有显著改善。
FiberTape 在 MPFL 重建中的应用可提高术后膝关节的稳定性，并具有良好的中期临床效果和较低的并发症发生率。
