Lyon-Ortho-Clinic, Clinique de la Sauvegarde, Ramsay Santé, Lyon, France.
ReSurg SA, Nyon, Switzerland.
Am J Sports Med. 2024 Jul;52(8):1984-1989. doi: 10.1177/03635465241253265. Epub 2024 Jun 3.
Recent systematic reviews on the outcomes of sulcus-deepening trochleoplasty with adjuvant medial patellofemoral ligament (MPFL) reconstruction at a follow-up of 2 to 6 years have found that the procedure grants good clinical outcomes with low redislocation rates. However, there is a lack of evidence in the literature regarding mid- and long-term follow-ups.
To evaluate the radiographic and clinical outcomes of thick-flap sulcus-deepening trochleoplasty with MPFL reconstruction at a minimum follow-up of 10 years to assess the signs of patellofemoral arthritis, incidence of recurrent dislocation, and grade of patient satisfaction.
Case series; Level of evidence, 4.
The authors evaluated a retrospective series of 43 patients (48 knees) who underwent sulcus-deepening trochleoplasty between 2003 and 2013. All patients underwent thick-flap sulcus-deepening trochleoplasty with additional MPFL reconstruction. All patients were assessed at a minimum follow-up of 10 years by an independent clinician who noted any patellar redislocation or reoperations in the operated knee and collected the International Knee Documentation Committee (IKDC), Kujala, and satisfaction scores. Furthermore, a radiographic examination was performed to assess patellar height using the Caton-Deschamps index and patellofemoral arthritis using the Iwano classification.
At a mean follow-up of 14.8 ± 2.1 years (range, 10-20 years), 4 patients (4 knees) were lost to follow-up (8.3%). The satisfaction, Kujala, and IKDC scores were 8.2 ± 1.6, 77.5 ± 14.4, and 65.7 ± 13.5, respectively. Only 1 patient reported a traumatic patellar dislocation (2%). Radiographs at the final follow-up were available for 34 knees, which revealed Iwano grade 1 in 14 knees (41%), Iwano grade 2 in 7 knees (21%), and no patellofemoral arthritis in 13 knees (38%).
Sulcus-deepening trochleoplasty with MPFL reconstruction provides satisfactory results and prevents patellar redislocations with no or minimal patellofemoral arthritis.
最近的系统评价显示，在 2 至 6 年的随访中，行沟加深滑车成形术联合辅助内侧髌股韧带（MPFL）重建术治疗的结果良好，脱位复发率低。然而，关于中期和长期随访的文献证据不足。
评估沟加深滑车成形术联合 MPFL 重建术的放射学和临床结果，随访时间至少 10 年，以评估髌股关节炎的迹象、复发性脱位的发生率和患者满意度的分级。
病例系列；证据水平，4 级。
作者回顾性评估了 2003 年至 2013 年期间行沟加深滑车成形术联合 MPFL 重建术的 43 例患者（48 膝）。所有患者均行厚瓣沟加深滑车成形术联合 MPFL 重建术。所有患者在至少 10 年的随访中由独立临床医生进行评估，记录手术侧膝关节有无髌骨再脱位或再次手术，并收集国际膝关节文献委员会（IKDC）、Kujala 和满意度评分。此外，进行放射学检查以使用 Caton-Deschamps 指数评估髌骨高度，使用 Iwano 分类评估髌股关节炎。
平均随访 14.8 ± 2.1 年（范围 10 至 20 年），4 例患者（4 膝）失访（8.3%）。满意度、Kujala 和 IKDC 评分分别为 8.2 ± 1.6、77.5 ± 14.4 和 65.7 ± 13.5。仅 1 例患者报告有创伤性髌骨脱位（2%）。最终随访时的放射学检查可用于 34 个膝关节，其中 14 个膝关节（41%）为 Iwano 1 级，7 个膝关节（21%）为 Iwano 2 级，13 个膝关节（38%）无髌股关节炎。
沟加深滑车成形术联合 MPFL 重建术可获得满意的结果，防止髌骨再脱位，且无或仅有轻微的髌股关节炎。
