Hobson Taylor E, Tomasevich Kelly M, Quinlan Noah J, Mortensen Alexander J, Aoki Stephen K
University of Utah, Department of Orthopaedic Surgery, Salt Lake City, Utah, U.S.A.
Arthrosc Sports Med Rehabil. 2021 Dec 20;4(2):e359-e370. doi: 10.1016/j.asmr.2021.10.011. eCollection 2022 Apr.
To evaluate mid-term outcomes after medial patellofemoral ligament (MPFL) reconstruction with and without tape augmentation in the skeletally mature adolescent population.
All patients under age 18 with recurrent patellar instability treated with surgery at a single institution by a single surgeon from January 2013 through June 2017 were identified by current procedural terminology codes. Inclusion criteria were (1) primary MPFL reconstruction, (2) minimum 3 years' follow-up, (3) skeletal maturity. Exclusion criteria were (1) bilateral MPFL reconstruction using different techniques on each knee, (2) prior surgery for patellar instability. Chart and imaging review was completed. Patients were contacted to complete a questionnaire, which included the International Knee Documentation Committee (IKDC) form.
Fifty-one of 92 eligible patients completed questionnaires. Two patients were excluded. Twenty patients underwent 23 non-augmented MPFL reconstructions; 29 patients underwent 33 augmented MPFL reconstructions. Group demographics were similar. At 4.9 ± 1.2 years follow-up, mean IKDC scores were 77.4 and 79.4 in the nonaugmentation and augmentation groups, respectively. Significantly fewer patients in the augmentation group experienced further injury to their ipsilateral knee compared to the non-augmentation group (6% vs 30%, = .019). Fewer knees in the augmentation group developed recurrent subjective instability or dislocation after initial surgery requiring surgical correction compared to knees in the nonaugmentation group, although this difference was not significant (6% vs 17%, = 0.181). Overall patient-reported outcomes were similar between the 2 groups.
There were no significant differences in patient-reported outcomes after MPFL reconstruction with or without tape augmentation. Tape augmentation significantly decreased the risk of subsequent ipsilateral knee injuries, although it did not show a significant difference in recurrent dislocations.
IV, therapeutic case series.
评估在骨骼成熟的青少年人群中，采用或不采用束带增强技术进行内侧髌股韧带（MPFL）重建后的中期疗效。
通过当前程序术语编码，确定2013年1月至2017年6月期间在单一机构由同一位外科医生为所有18岁以下复发性髌骨不稳定患者实施手术的情况。纳入标准为：（1）初次MPFL重建；（2）至少3年的随访；（3）骨骼成熟。排除标准为：（1）双膝采用不同技术进行双侧MPFL重建；（2）既往有髌骨不稳定手术史。完成病历和影像学检查。联系患者完成一份问卷，其中包括国际膝关节文献委员会（IKDC）表格。
92例符合条件的患者中有51例完成问卷。排除2例患者。20例患者接受了23次非增强型MPFL重建；29例患者接受了33次增强型MPFL重建。两组人口统计学特征相似。在4.9±1.2年的随访中，非增强组和增强组的平均IKDC评分分别为77.4和79.4。与非增强组相比，增强组同侧膝关节再次受伤的患者明显更少（6%对30%，P = 0.019）。与非增强组的膝关节相比，增强组中因初次手术后出现复发性主观不稳定或脱位而需要手术矫正的膝关节更少，尽管这种差异不显著（6%对17%，P = 0.181）。两组患者总体报告的结果相似。
MPFL重建采用或不采用束带增强技术，患者报告的结果无显著差异。束带增强技术显著降低了同侧膝关节后续受伤的风险，尽管在复发性脱位方面未显示出显著差异。
IV，治疗性病例系列。
