A simple technique for reconstruction of medial patellofemoral ligament with bone-fascia tunnel fixation at the medial margin of the patella: a 6-year-minimum follow-up study

作者：Li, Jia; Li, Yongqian; Wei, Jingchao; Wang, Jianzhao; Gao, Shijun; Shen, Yong^*

来源：Journal of Orthopaedic Surgery and Research, 2014, 9(1): 66.

DOI：10.1186/s13018-014-0066-7

• Patella
• Instability
• Medial patellofemoral ligament
• Reconstruction
• Fixation

Background: Medial patellofemoral ligament (MPFL) reconstruction has become an accepted technique to treat patellofemoral instability, and numerous surgical techniques have been described to reconstruct the MPFL. We describe a MPFL reconstruction procedure where bone-fascia tunnel fixation occurs at the medial margin of the patella for recurrent patellar dislocation.
Objective: MPFL reconstruction is the preferred operative treatment for recurrent patellar dislocation. The purpose of this study was to report a simple technique for reconstruction of medial patellofemoral ligament with bone-fascia tunnel fixation at the medial margin of the patella for recurrent patellar dislocation and to evaluate the results at 6-year-minimum follow-up.
Methods: The study included 65 patients (28 males, 37 females; mean age, 29.4 +/- 5.6 years) who underwent MPFL reconstruction using the bone-fascia tunnel fixation at the medial margin of the patella technique and who were followed for a mean duration of 78.5 +/- 3.8 months. Objective assessment, Kujala scale, Lysholm score, and Tegner activity score were obtained preoperatively and at the time of final follow-up.
Results: There were no patellar complications, including redislocation, in the present study. The congruence angle had significant improvement from 19.2 degrees +/- 6.3 degrees before surgery to -6.03 degrees +/- 0.50 degrees at the last follow-up. The lateral patellar angle had significant improvement from -6.9 degrees +/- 3.5 degrees before surgery to 5.1 degrees +/- 2.4 degrees at the last follow-up. The patellar tilt angle had significant improvement from 24.5 degrees +/- 5.2 degrees before surgery to 12.30 degrees +/- 1.90 degrees at the last follow-up. The Kujala score was significantly increased from 52.9 +/- 3.2 points preoperatively to 90.1 +/- 5.8 points postoperatively (P < 0.05). The mean Lysholm score was significantly increased from 47.2 +/- 5.2 to 92.5 +/- 6.2 points postoperatively (P < 0.05). The Tegner activity score improved overall from 3.1 +/- 0.6 points to 5.8 +/- 0.9 points at follow-up.
Conclusion: We have done a simple technique where the MPFL is reconstructed safely to avoid patella fracture, anatomically to restore physiological kinematics and stability, and economically to reduce costs with bone-fascia tunnel fixation at the medial margin of the patella.

• 出版日期2014-8-15
• 单位河北医科大学; 河北省人民医院