Department of Orthopaedic Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
Clin Orthop Surg. 2022 Sep;14(3):386-392. doi: 10.4055/cios21093. Epub 2022 Jun 30.
This study evaluated the outcomes of medial patellofemoral ligament (MPFL) reconstruction using a gracilis tendon suture technique for patients with patellar instability. Potential factors affecting clinical efficacy were also evaluated.
This study included 22 patients diagnosed with patellar instability, who underwent MPFL reconstruction using a gracilis tendon. Their mean age was 21.5 years (range, 15-48 years), and the mean follow-up period was 26.8 months (range, 12-66 months). Clinical evaluation included the determination of Kujala, Lysholm, and Tegner scores. Radiographic evaluation included changes in congruence angle and arthritic changes in the patellofemoral joint. Additionally, patients were examined for any complications, including recurrent dislocation. Factors affecting clinical efficacy were also evaluated.
All clinical scores improved at final follow-up. The mean congruence angle improved from 23.6° before surgery to -6.5° at final follow-up. Two of 15 patients developed osteoarthritic changes in the patellofemoral joint. Dislocation recurred in 2 patients with type C trochlear dysplasia, which showed a statistically significant association with recurrent dislocation when compared to type A and B dysplasia ( = 0.026). Kujala scores were significantly lower among patients with abnormal patellar tilts ( = 0.038), and Lysholm scores were significantly lower among patients with femoral internal rotation deformity ( = 0.024).
Satisfactory results were obtained after MPFL reconstruction using a gracilis tendon suture technique for patients with patellar instability. However, dislocation recurred in patients with type C trochlear dysplasia, and clinical efficacy was lower among patients with femoral internal rotation and patellar tilt.
本研究评估了使用股薄肌腱缝合技术进行内侧髌股韧带（MPFL）重建治疗髌股不稳定患者的疗效。同时评估了影响临床疗效的潜在因素。
本研究纳入了 22 例诊断为髌股不稳定的患者，他们接受了 MPFL 重建手术，使用股薄肌腱。患者的平均年龄为 21.5 岁（范围，15-48 岁），平均随访时间为 26.8 个月（范围，12-66 个月）。临床评估包括 Kujala、Lysholm 和 Tegner 评分。影像学评估包括髌骨吻合角和髌股关节关节炎的变化。此外，还检查了患者是否有任何并发症，包括复发性脱位。同时评估了影响临床疗效的因素。
所有临床评分在最终随访时均有所改善。髌骨吻合角从术前的 23.6°改善至最终随访时的-6.5°。15 例患者中有 2 例出现髌股关节关节炎改变。2 例 C 型滑车发育不良患者出现复发性脱位，与 A 型和 B 型发育不良相比，与复发性脱位有统计学显著关联（ = 0.026）。存在异常髌骨倾斜的患者的 Kujala 评分明显较低（ = 0.038），存在股骨内旋畸形的患者的 Lysholm 评分明显较低（ = 0.024）。
使用股薄肌腱缝合技术进行 MPFL 重建治疗髌股不稳定患者可获得满意的疗效。然而，C 型滑车发育不良患者出现复发性脱位，股骨内旋和髌骨倾斜患者的临床疗效较低。
