Department of Orthopedic Surgery, New York University Langone Health, 333 E 38(th) Street, New York, NY 10016, USA.
Department of Orthopedic Surgery, New York University Langone Health, 333 E 38(th) Street, New York, NY 10016, USA.
J ISAKOS. 2022 Feb;7(1):3-6. doi: 10.1016/j.jisako.2021.10.004. Epub 2021 Nov 17.
An isolated medial patellofemoral ligament (MPFL) reconstruction (MPFLR) has been demonstrated to be an effective treatment option in the prevention of patellar instability, but there is growing support for performing a tibial tubercle osteotomy (TTO) in patients with an elevated tibial tubercle-trochlear groove distance. The purpose of this study was to evaluate the impact of adding a TTO to MPFLR on patient-reported outcomes.
A retrospective review of patients who underwent MPFLR with or without TTO with a minimum of 12-month follow-up was performed. Patients in both groups were matched based on age, gender, and follow-up time. Recurrent instability (including redislocation and subluxation), visual analogue scale (VAS) score, Kujala score, and satisfaction were evaluated.
There were 59 patients who underwent MPFLR with concomitant TTO performed at our institution and met our inclusion and exclusion criteria. These patients were then matched to patients undergoing isolated MPFLR based on demographics and follow-up time. The mean age was 25.0 years, 76.3% were female, and the mean follow-up time was 49 months. There was a significant difference in mean tibial tubercle-trochlear groove distance (19.8 ± 3.9 vs. 14.1 ± 2.8) between groups. There was no significant difference in VAS (1.48 ± 2.0 vs. 1.49 ± 2.1, p = 0.972), satisfaction (86.1% ± 24.2% vs. 81.2% ± 27.9, p = 0.311) or revision surgeries (10.2% vs. 10.2%) between groups.
Matched patients undergoing MPFLR with TTO compared with isolated MPFLR demonstrate no statistically significant difference in patient-reported outcomes, levels of pain, and satisfaction postoperatively. Furthermore, the addition of a TTO does not increase the risk of further surgery or complications.
III, retrospective comparative study.
孤立的内侧髌股韧带（MPFL）重建（MPFLR）已被证明是预防髌骨不稳定的有效治疗选择，但越来越多的人支持在胫骨结节-滑车沟距离升高的患者中进行胫骨结节切开术（TTO）。本研究的目的是评估在 MPFLR 中添加 TTO 对患者报告结果的影响。
对接受 MPFLR 治疗的患者进行回顾性研究，其中包括接受或不接受 TTO 治疗的患者，随访时间至少为 12 个月。两组患者均根据年龄、性别和随访时间进行匹配。评估复发性不稳定（包括再脱位和半脱位）、视觉模拟评分（VAS）评分、Kujala 评分和满意度。
在我们机构进行的 59 例 MPFLR 伴发 TTO 的患者符合我们的纳入和排除标准，并满足我们的纳入和排除标准。然后根据人口统计学和随访时间将这些患者与接受单纯 MPFLR 的患者进行匹配。平均年龄为 25.0 岁，76.3%为女性，平均随访时间为 49 个月。两组间胫骨结节-滑车沟距离的平均值有显著差异（19.8±3.9 与 14.1±2.8）。两组 VAS（1.48±2.0 与 1.49±2.1，p=0.972）、满意度（86.1%±24.2%与 81.2%±27.9，p=0.311）或翻修手术（10.2%与 10.2%）差异均无统计学意义。
与单纯 MPFLR 相比，接受 MPFLR 联合 TTO 的患者在术后患者报告的结果、疼痛水平和满意度方面无统计学差异。此外，添加 TTO 并不会增加进一步手术或并发症的风险。
III，回顾性比较研究。
