Curative effect of recurrent patellar dislocation through arthroscopic lateral retinacular release combined with medial patellofemoral ligament reconstruction
HUANG Yuan-xia, DUAN Yong-zhuang, WANG Li-min, XU Hai-bin
Chinese Journal of Clinical Anatomy ›› 2017, Vol. 35 ›› Issue (1) : 102-105.
Curative effect of recurrent patellar dislocation through arthroscopic lateral retinacular release combined with medial patellofemoral ligament reconstruction
Objective To investigate clinical effect of arthroscopic lateral retinacular release combined with medial patellofemoral ligament reconstruction on recurrent patellar dislocation. Methods 19 cases were admitted into our hospital for arthroscopic lateral retinacular release combined with reconstruction the medial patellofemoral ligament from January 2012 to January 2015. With Regular follow-up after surgery, we recorded preoperative and postoperative radiographic results, Lysholm knee function score and Kujala score changes of patellofemoral joint, ligament length reconstruction. Results 19 cases were followed up for 12~48 (25.7±8.56) months after surgery, no patella redislocation and fear patellofemoral pain syndrome, no aggravation, X-ray Q angle in the normal range were found, and the knee joint CT (at 45 °) showed that patients with the lateral patellar articular surface opening angle had it increased to (11.2±5.1)°(5°~18°) postoperatively from an average (-1.2±6.8)°(-16°~8°) preoperatively, with significant difference detected (P<0.01). Lysholm scores and Kujala patellofemoral joint score one year after surgery improved significantly compared with that prior to surgery. Average length of ligament after reconstruction immediately after operation was about (57.81±6.76) mm, and it increased to about (58.36±6.87) mm one year after surgery, with no significant relaxation found. Conclusion Arthroscopically assisted lateral retinacular release combined with medial patellofemoral ligament reconstruction can effectively restore the position and function of the patellofemoral joint and prevent recurrence, and the curative effect is satisfactory.
Arthroscopy / Patellofemoral joint / Dislocation / Medial patellofemoral ligament / Reconstruction
[1] Hing CB, Smith TO, Donell S, et al．Surgical versus non surgical interventions for treating patellar dislocation[J]. Cochrane Database Syst Rev, 2011,9(11):CD008106.
[2] Arnbjörnsson A, Egund N, Rydling O, et al. The natural history of recurrent dislocation of the patella: long-term results of conservative and operative treatment[J]. J Bone Joint Surg Br, 1992, 74(1): 140-142.
[3] Hautamaa PV, Fithian DC, Kaufman KR, et al. Medial soft tissue restraints in lateral patellar instability and repair[J]. Clin Orthop Relat Res, 1998, 349: 174-182.
[4] 赵建宁，陈烁. 髌骨脱位的规范化治疗方案[J]. 中国骨伤，2015,28（7）：585-589.
[5] 冯华，张辉. 髌股关节不稳定-临床评估与治疗[M].人民军医出版社，2014, 7:1-91.
[6] Merican AM, Amis AA. Anatomy of the lateral retinaculum of the knee[J]. J Bone Joint Surg Br, 2008, 90(4):527-534.
[7] Sillanpää PJ, Peltola E, Mattila VM, et al．Femoral avulsion of the medial patellofemoral ligament after primary traumatic patellar dislocation predicts subsequent instability in men：a mean 7 year nonoperative follow up study[J]．Am J Sports Med, 2009, 37(8):1513-1521.
[8] Rhee SJ, Pavlou G, Oakley J, et al. Modern management of patellar instability[J]. Int Orthop, 2012, 36(12):2447-2456.
[9] Philippot R, Chouteau J, Wegrzyn J, et al. Medial patellofemoral ligament anatomy：implications for its surgical reconstruction[J]．Knee Surg Sports Traumatol Arthrosc, 2009, 17(5):475-459.
[10] Andrikoula S, Tokis A, Vasiliadis HS, et al. The extensor mechanism of the knee joint: an anatomical study[J]. Knee Surg Sports Traumatol Arthrosc, 2006, 14(3):214-220.
[11]Palmu S, Kallio PE, Donell ST, et al. Acute patellar dislocation in children and adolescents：a randominzed clinical trial[J]. J Bone Joint Surg Am, 2008, 90(3):463-470.
[12]Bicos J, Fulkerson JP, Amis A. Current concepts review:the medial patellofemoral ligament[J]. Am J Sports Med, 2007, 35(3):484-92.
[13]Duchman KR, DeVries NA, McCarthy MA, et al. Biomechanical evaluation of medial patellofemoral ligament reconstruction[J]. Iowa Orthop J, 2013, 33:64-69.
[14]王宁，刘玉杰，杨玉明，等. 自体腘绳肌腱移植治疗复发性髌骨脱位[J]. 解放军医学院学报，2009，30（5）:603-605.
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