A %26quot;sandwich%26quot; method of reconstruction of the medial patellofemoral ligament using a titanium interference screw for patellar instability in skeletally immature patients

作者：Kumahashi Nobuyuki^*; Kuwata Suguru; Tadenuma Taku; Kadowaki Masaru; Uchio Yuji

来源：Archives of Orthopaedic and Trauma Surgery, 2012, 132(8): 1077-1083.

DOI：10.1007/s00402-012-1516-5

• Interference fit anchoring system
• Medial patellofemoral ligament
• Patellar instability
• Reconstruction
• Epiphyseal line

No standard surgical procedure for medial patellofemoral ligament (MPFL) reconstruction exists in skeletally immature patients with patellar instability. This study aimed to evaluate the clinical effectiveness of a novel reconstruction technique for the MPFL in patients with patellar instability because of non-closure of the epiphyseal line. %26lt;br%26gt;The %26quot;sandwich%26quot; method was fixation of the patella between a double-stranded semitendinosus tendon through the posterior third of the femoral insertion of the medial collateral ligament (MCL) as a pulley with a titanium interference screw in a single patellar tunnel. Five knees in five patients were studied: four with recurrent and one with habitual patellar dislocations. Subjects underwent MPFL reconstruction with or without lateral release. Patients were evaluated using pre-operative and post-operative physical and radiographic examinations, including apprehension testing, assessment of tilting and congruence angles, medial and lateral shift ratios under stress measured using X-ray imaging, and Kujala and Lysholm scores. %26lt;br%26gt;No patient experienced recurrent post-operative episodes of dislocation or subluxation. By the final follow-up, patellar apprehension had disappeared in all patients. In addition, all patients showed significant improvement in the following: tilting angle, congruence angle, lateral shift ratio, Kujala score, and Lysholm score. %26lt;br%26gt;The MPFL reconstruction methods, using a double-stranded semitendinosus autograft and sparing the femoral physeal line in non-closure of the epiphyseal line, provide acceptable short-term results for the treatment of patellar instability.

• 出版日期2012-8