Nazeer Muhammed Ehsan, Goel Sagar, Nazeer Muhammed, Sreenivasan Gowrishankar, Muhammed Mohsin Nazeer, Shajil Suzaan
Orthopedics, Cumberland Infirmary, North Cumbria Integrated Care Trust, Carlisle, UK.
Department of Orthopedics, KIMS Health, Thiruvananthapuram, Kerala, India.
Adv Orthop. 2023 Sep 14;2023:6647760. doi: 10.1155/2023/6647760. eCollection 2023.
Lateral patellar dislocation is frequently observed among teenagers and young adults. There is no consensus on the best type of graft or fixation strategy for the femur and patella, and complications such as iatrogenic patella fracture, tunnel malposition, and grafting failure are common. The objective of our research is to find out the functional outcome of a new method of medial patellofemoral ligament (MPFL) reconstruction, which involves two key components: (1) patellar fixation is accomplished by suturing the two limbs of the looped doubled hamstring graft in a divergent fashion to the retinaculum at the medial border of the upper half of patella and (2) the placement of a suture anchor tied to the graft at the isometric point on the medial femur condyle.
This study is a retrospective assessment of patients who underwent MPFL reconstruction at our hospital between September 2018 and August 2020. Patients were monitored for at least 2 years after the initial procedure until August 2022.
A total of 29 patients were recruited for the study, with 22 being females and the average age being 30.38 years. During the postoperative period, none of the participants experienced instability, redislocation, patellar/femoral fractures, or abnormal distal femur growth. The Tegner-Lysholm knee score was good to excellent for 17 (58.6%) participants, fair for 10 (34.5%) participants, and poor for 2 (6.9%) participants. The Kujala anterior knee pain score was more than 80 for 19 (65.5%) participants.
This research presents a significant achievement rate of the surgical procedure, accompanied by the mean Tegner-Lysholm knee score of 82.68 and the mean Kujala anterior knee pain score of 82.71. Notably, there were no complications observed in the postoperative period.
髌外侧脱位在青少年和年轻成年人中较为常见。对于股骨和髌骨的最佳移植物类型或固定策略尚无共识，医源性髌骨骨折、隧道位置不当和移植物失败等并发症很常见。我们研究的目的是找出一种新的髌股内侧韧带（MPFL）重建方法的功能结果，该方法涉及两个关键部分：（1）通过将环形双股绳肌移植物的两肢以发散方式缝合到髌骨上半部分内侧边缘的支持带上完成髌骨固定；（2）在股骨内侧髁的等长点处放置一个缝合锚并系在移植物上。
本研究是对2018年9月至2020年8月在我院接受MPFL重建的患者进行的回顾性评估。患者在初次手术后至少监测2年，直至2022年8月。
共招募了29名患者进行研究，其中女性22名，平均年龄为30.38岁。在术后期间，没有参与者出现不稳定、再脱位、髌骨/股骨骨折或股骨远端生长异常。17名（58.6%）参与者的Tegner-Lysholm膝关节评分为良好至优秀，10名（34.5%）参与者为中等，2名（6.9%）参与者为差。19名（65.5%）参与者的Kujala膝前疼痛评分为80分以上。
本研究显示该手术程序有显著的成功率，Tegner-Lysholm膝关节平均评分为82.68，Kujala膝前疼痛平均评分为82.71。值得注意的是，术后未观察到并发症。
