Medial patellofemoral ligament reconstruction with autogenous tendon under arthroscopy in the treatment of recurrent dislocation of the patella

Abstract:

Objective：To discuss the curative efficacy of tibial tubercle anteromedial transfer，medial patellofemoral ligament reconstruction and arthroscopic lateral retinaculum release in treating recurrent patella dislocation. Methods：Twenty-eight cases of recurrent patella dislocation were treated by tibial tubercle anteromedial transfer，medial patellofemoral ligament reconstruction and arthroscopic lateral retinaculum release，and patellar track of all patients were probed under arthroscopy intra-operatively. Patellar CT scanning was used to detect patellofemoral angle，tilt angle and lateral shift；pre-operation and post-operation knee joint function was assessed using Kujala，Lyshoim and Tegner scores. Results：All patients were followed for 18.5 months in average（ranged from 12 to 33 months. Knee joint symptoms improved at the last follow-up.CT scanning showed that patellofemoral angle，tilt angle and lateral shift were respectively reduced from pre-operative（33.85±4.30）°，（12.23±1.78）°，（47.70±2.61）% to post-operative（11.58±1.86）°，（8.35±1.52）°，（8.80±1.63）%，with statistically significant differences（P=0.000）. Kujala，Lysholm and Tegner function scores were improved from pre-operative（57.70±2.93），（56.30±2.53），（3.40±0.94） to post-operative（89.90±2.87），（91.40±2.06），（5.20±1.07），with statistically significant differences（P=0.000）. Conclusion：It is effective to treat recurrent patella dislocation by ways of tibial tubercle anteromedial transfer，medial patellofemoral ligament reconstruction and arthroscopic lateral retinaculum release. The operation aims to improve the stability of the knee and prevent recurrence，which is conducive to recovering knee function.