Hong Sung-Yup, Kim Seounghyeon, Lee Hyo-Beom, Song Won-Ho, Kim Jeehyoung, Seo Young-Jin, Song Si Young
Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea.
Orthop J Sports Med. 2024 Oct 28;12(10):23259671241283411. doi: 10.1177/23259671241283411. eCollection 2024 Oct.
There are few studies that have examined clinical and radiological outcomes at 5 years after isolated medial patellofemoral ligament (MPFL) reconstruction. To date, midterm outcomes after isolated double-bundle (DB) MPFL reconstruction are not well known.
Isolated DB MPFL reconstruction using a patellar suture anchor technique would lead to improved functional scores and radiological findings, and these improvements would remain stable over the 5-year postoperative period.
Case series; Level of evidence, 4.
Isolated MPFL reconstruction was performed in patients with recurrent patellar instability between March 2013 and February 2017. Clinical and functional evaluations were performed via an interview using the Kujala, Lysholm, and Tegner scores preoperatively and at 6, 12, 24, and 60 months postoperatively. Radiographs were taken preoperatively, immediately postoperatively, and at 24 and 60 months after surgery. Radiographic assessments included measuring the modified Insall-Salvati ratio, congruence angle, and lateral patellofemoral angle.
A total of 31 patients (31 knees) underwent isolated MPFL reconstruction; 4 patients did not complete 5-year follow-up, and thus, 27 patients (27 knees) were enrolled in the study. The mean age at the time of surgery was 22.0 ± 6.4 years (range, 14-32 years). All clinical and functional scores significantly improved in the first 2 years ( < .001), with the mean Kujala, Lysholm, and Tegner scores improving from 52.7 to 90.7, 49.6 to 92.7, and 2.9 to 5.1, respectively. There was no significant difference in scores between 2- and 5-year follow-up. All radiographic parameters significantly improved between preoperatively and immediately postoperatively ( < .001), with mean values for the modified Insall-Salvati ratio, congruence angle, and lateral patellofemoral angle improving from 1.7° to 1.6°, 5.7° to -6.6°, and 3.0° to 5.9°, respectively. No significant differences were observed in radiographic measurements between the postoperative time points. No patients experienced a patellar redislocation or fracture.
The prospective analysis of isolated DB MPFL reconstruction at 5-year follow-up showed that clinical and radiological outcomes significantly improved postoperatively and were maintained to 5 years. These midterm results suggest that isolated DB MPFL reconstruction is an effective treatment option for patients with patellar instability.
很少有研究探讨孤立性髌股内侧韧带（MPFL）重建术后5年的临床和影像学结果。迄今为止，孤立性双束（DB）MPFL重建术后的中期结果尚不清楚。
采用髌骨缝合锚技术进行孤立性DB MPFL重建将导致功能评分和影像学表现得到改善，并且这些改善在术后5年内保持稳定。
病例系列；证据等级，4级。
2013年3月至2017年2月期间，对复发性髌骨不稳定患者进行孤立性MPFL重建。术前以及术后6、12、24和60个月通过访谈使用Kujala、Lysholm和Tegner评分进行临床和功能评估。术前、术后即刻以及术后24和60个月拍摄X线片。影像学评估包括测量改良Insall-Salvati比率、适合角和髌股外侧角。
共有31例患者（31膝）接受了孤立性MPFL重建；4例患者未完成5年随访，因此，27例患者（27膝）纳入本研究。手术时的平均年龄为22.0±6.4岁（范围14 - 32岁）。所有临床和功能评分在前2年显著改善（P <.001），Kujala、Lysholm和Tegner评分的平均值分别从52.7提高到90.7、从49.6提高到92.7、从2.9提高到5.1。2年和5年随访之间的评分无显著差异。术前和术后即刻之间所有影像学参数均显著改善（P <.001），改良Insall-Salvati比率、适合角和髌股外侧角的平均值分别从1.7°提高到1.6°、从5.7°提高到 - 6.6°、从3.0°提高到5.9°。术后各时间点的影像学测量未观察到显著差异。没有患者发生髌骨再脱位或骨折。
对孤立性DB MPFL重建进行5年随访的前瞻性分析表明，术后临床和影像学结果显著改善并维持至5年。这些中期结果表明，孤立性DB MPFL重建是治疗髌骨不稳定患者的一种有效治疗选择。
