Department of Orthopedics, Renmin Hospital of Wuhan University, 238, Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China.
Department of Emergency, Renmin Hospital of Wuhan University, Wuhan, China.
J Orthop Surg Res. 2023 Oct 12;18(1):771. doi: 10.1186/s13018-023-04272-9.
Knee stability can be safely and reliably restored using medial patellofemoral ligament (MPFL) reconstruction, which is widely recognized in patients with recurrent lateral patellar instability. However, the literature regarding its influence on static balance control is limited. Thus, this study aimed to assess the impact of MPFL reconstruction on balance control and determine its functional significance.
The study comprised 26 patients with recurrent lateral patellar instability, scheduled for MPFL reconstruction, and 26 matched healthy controls who underwent double-leg stance static posturographic tests pre- and postoperatively on a vertical force platform. Four test conditions were performed with their eyes open and closed, without and with foam support to evaluate the balance control of all participants. The International Knee Documentation Committee subjective knee form, Lysholm knee scoring scale, Tampa scale for kinesiophobia, and active range of motion of the affected knee were synchronously obtained and assessed.
More postural sway was observed in patients compared to the healthy controls, 11 ± 5 days preoperatively (p < 0.01). However, 374 ± 23 days postoperatively, postural sway between the patients and control subjects was comparable (p > 0.05). Patients following MPFL reconstruction demonstrated better postural stability (p < 0.01). Significant ameliorations were found in all clinical assessments in the study patients postoperatively (p < 0.01).
Patients with recurrent lateral patellar instability have inefficient balance control. Static bipedal balance control can be improved under surface perturbation in these patients one year after isolated MPFL reconstruction that enhances the possibility of normal restoration of postural stability. Structural recovery of the ligament could help restore the sensorimotor efficiency and generate the compensatory and anticipatory balance regulation strategies, thereby improving joint function.
内侧髌股韧带（MPFL）重建可安全可靠地恢复膝关节稳定性，这在复发性外侧髌股不稳定患者中得到广泛认可。然而，关于其对静态平衡控制影响的文献有限。因此，本研究旨在评估 MPFL 重建对平衡控制的影响，并确定其功能意义。
本研究纳入 26 例复发性外侧髌股不稳定患者，计划进行 MPFL 重建，并纳入 26 例匹配的健康对照者，他们在垂直力平台上进行双足站立静态姿势描记术测试，术前和术后均进行。在睁眼和闭眼、无和有泡沫支撑的情况下进行了四项测试条件，以评估所有参与者的平衡控制。同时获得并评估国际膝关节文献委员会（IKDC）主观膝关节评分、Lysholm 膝关节评分量表、Tampa 运动恐惧量表和患膝主动活动范围。
与健康对照组相比，患者术前（p<0.01）存在更多的姿势摆动，为 11±5 天。然而，术后 374±23 天，患者和对照组之间的姿势摆动没有差异（p>0.05）。接受 MPFL 重建的患者表现出更好的姿势稳定性（p<0.01）。研究患者术后所有临床评估均有显著改善（p<0.01）。
复发性外侧髌股不稳定患者的平衡控制效率较低。孤立性 MPFL 重建一年后，在表面干扰下，这些患者的静态双足平衡控制可以得到改善，从而有可能恢复正常的姿势稳定性。韧带的结构恢复有助于恢复感觉运动效率，并产生补偿性和预期性平衡调节策略，从而改善关节功能。
