Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, c/o Lab Biomeccanica ed Innovazione Tecnologica, Via Cesare Pupilli 1, Bologna, Italy.
DIBINEM, University of Bologna, Bologna, Italy.
Arch Orthop Trauma Surg. 2024 Aug;144(8):3419-3425. doi: 10.1007/s00402-024-05493-1. Epub 2024 Aug 23.
To evaluate long-term clinical outcomes and redislocation rate after medial patellotibial ligament reconstruction.
A total of 26 knees with mean age 26.3 ± 10.6 years (25 patients, 7 males and 18 females) treated for patellar instability (at least two objective dislocations) with medialization of the patellar tendon medial third were evaluated with an intermediate clinical follow-up (FU) at a mean of 6.5 ± 2.1 years and with a final telephone interview follow-up at mean of 15.6 ± 2.5 years (11.4-20.1). Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC), Kujala, Visual Analog Scale (VAS) for pain and Tegner activity scores were used. Information about further redislocation and knee surgery was also collected.
All the clinical scores had a significant improvement compared to preoperative status (WOMAC pre-op 55.9 ± 27.2 vs. WOMAC final FU 80.8 ± 22.2; KUJALA pre-op 41.0 ± 24.0 vs. KUJALA final FU 77.2 ± 24.1; VAS pre-op 6.0 ± 3.1 vs. VAS final FU 3.44 ± 2.35; TEGNER pre-op 2.1 ± 2.0 vs. TEGNER final FU 3.6 ± 1.8; p < 0.001), and the outcomes remained stable at the final follow-up compared to the intermediate follow-up (p > 0.05). A total of 4 knees had at least one redislocation at the final follow-up, while 3 knees underwent total knee replacement surgery. The redislocation-survival rate at 5 years is 92%, meanwhile is 84% at 10 and 15 years.
MPTL reconstruction produced good clinical results and a survival rate of 84% at a mean of 16 years follow-up and could be considered as associated procedure in case of patellofemoral instability.
Level IV.
评估内侧髌股韧带重建术后的长期临床结果和再脱位率。
共 26 例膝关节，平均年龄 26.3±10.6 岁（25 例患者，7 例男性，18 例女性），因髌股不稳定（至少有 2 次客观脱位）接受髌腱内侧三分之一的内侧化治疗，采用中期临床随访（平均 6.5±2.1 年）和最终电话随访（平均 15.6±2.5 年，11.4-20.1 年）进行评估。采用 Western Ontario 和 MacMaster 大学骨关节炎指数（WOMAC）、Kujala、疼痛视觉模拟量表（VAS）和 Tegner 活动评分进行评估。还收集了关于进一步再脱位和膝关节手术的信息。
与术前相比，所有临床评分均有显著改善（WOMAC 术前 55.9±27.2 与最终随访时 WOMAC 80.8±22.2；Kujala 术前 41.0±24.0 与最终随访时 Kujala 77.2±24.1；VAS 术前 6.0±3.1 与最终随访时 VAS 3.44±2.35；TEGNER 术前 2.1±2.0 与最终随访时 TEGNER 3.6±1.8；p<0.001），且在最终随访时与中期随访相比，结果保持稳定（p>0.05）。最终随访时共有 4 例膝关节至少有 1 次再脱位，3 例膝关节行全膝关节置换术。5 年时的再脱位生存率为 92%，10 年和 15 年时的生存率分别为 84%。
MPTL 重建术后临床效果良好，16 年平均随访时的生存率为 84%，可作为髌股不稳定的相关手术。
IV 级。
