Bone and Joint Injury
Clincical efficacy of medial patellofemoral ligament reconstruction combined with tibial tuberosity osteotomy in treatment of recurrent patellar dislocation associated with patella alta
Ma Chao, Lin Yangjing, Xiong Ran, Luo Jiangming, Gu Lingchuan, Chen Hao, Yang Pengfei, Peng Yang, Guo Lin, Yang Liu
Published 2017-10-15
Cite as Chin J Trauma, 2017,33(10): 911-917. DOI: 10.3760/cma.j.issn.1001-8050.2017.10.010
Abstract
ObjectiveTo compare the efficacy of tibial tuberosity osteotomy (TTO) combined with medial patellofemoral ligament reconstruction (MPFLR) with simple TTO in treatment of recurrent patella dislocation associated with patella alta.
MethodsFrom July 2010 to December 2015, 50 patients with recurrent patella dislocation and patella alta were included in this study. There were 15 males and 35 females with an average age of 20.6 years. These patients received surgical treatment and their clinical data were collected and retrospectively analyzed by case-control study. According to surgical methods, patients were divided into TTO group (32 cases) and MPFLR+ TTO group (18 cases). The differences between preoperative status and postoperative status were evaluated by knee function scores including Tegner, international knee documentation committee (IKDC), Kujala scores, knee injury and osteoarthritis outcome score (KOOS). Patellar stability was checked at the last follow-up visit.
ResultsThe TTO group and MPFLR+ TTO group were followed up for (50.9±17.8)months and (22.3±10.1)months, respectively. Two patients occurred recurrent dislocation in TTO group, who showed positive in both extrapolation test and extrapolation apprehension test at 0°flexions of knee. All patients in MPFLR+ TTO group did not occur recurrent dislocation, who showed negative in both extrapolation test and extrapolation apprehension test at 0°flexions of knee. There was no significant difference between preoperative and postoperative results in TTO group in Tegner score (P>0.05), KOOS scores in pain and daily life activities subdomains (P>0.05), while differences in the rest of scores were statistically significant (P<0.05). Compared with TTO group, the differences of all scores were statistically significant (P<0.05) and KOOS scores in the pain and daily life activities subdomains were significantly improved postoperatively in MPFLR+ TTO group (P<0.05).
ConclusionsFor patients with recurrent patellar dislocation associated with patella alta, both surgical methods are found to be effective. Postoperative improvements in pain and daily life activities are less obvious in TTO. While postoperative improvements in pain and daily life activities in MPFLR+ TTO are superior to those of TTO.
Key words:
Patellar dislocation; Surgical procedures, operative; Patella alta
Contributor Information
Ma Chao
Center for Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
Lin Yangjing
Xiong Ran
Luo Jiangming
Gu Lingchuan
Chen Hao
Yang Pengfei
Peng Yang
Guo Lin
Yang Liu
