Medial patellofemoral ligament reconstruction with autologous long fibular muscle tendon under arthroscopy for treatment of patellar dislocation / 中华创伤杂志

ABSTRACT

Objective:To evaluate the clinical efficacy of medial patellofemoral ligament (MPFL) reconstruction with autologous long fibular muscle tendon assisted by arthroscope for treatment of patellar dislocation.Methods:A retrospective case series study was carried out to analyze data of 15 patients with patellar dislocation treated from February 2016 to June 2018 at Affiliated Hospital of Nantong University. There were 6 males and 9 females with an average age of 26.8 years (range, 14-46 years). All patients had lateral patellar dislocation, including 14 patients with recurrent patellar dislocation and 1 with habitual dislocation. All patients underwent arthroscopic exploration and MPFL reconstruction with autologous long fibular muscle tendon, among which 12 underwent arthroscopic lateral retinacular release simultaneously, 3 underwent MPFL reconstruction only. Operation duration, incision healing, function of ankle joint, extrapolation test, extrapolation apprehension test, and complications were recorded. Knee joint function was assessed using Lysholm score, Kujala score, and International Knee Documentation Committee (IKDC) score before operation, at postoperative 6 months and at latest follow-up.Results:All patients were followed up for 9-33 months with an average of 24.2 months. The operation duration was 65-85 minutes (average 71.2 minutes). All incisions healed by first intention. Ankle joint function was satisfying without pain and discomfort. At the latest follow-up, no recurrent dislocation of patella occurred, with negative results of the extrapolation test and extrapolation apprehension test at 20 degrees flexion of knee. Six months after surgery, the patients completely returned to normal activities. The Lysholm scores, Kujala score and IKDC score were improved from preoperative (51.7±2.5)points, (52.8±3.3)points, (47.1±3.3)points to (84.6±3.2)points, (85.0±3.3)points, (82.5±2.0)points respectively at postoperative 6 months, and to (89.5±1.9)points, (89.2±2.8)points, (87.5±2.2)points respectively at the latest follow-up ( P<0.01). Conclusions:MPFL reconstruction with autologous long fibular muscle tendon assisted by arthroscope, supplemented by lateral retinacular release, can attain curative effect for patellar dislocation and ameliorate knee function.