Strengthening of the patellofemoral ligament by rivet fixation of the dissociative semitendinosus tendon for recurrent patellar dislocation

Abstract

Objective To investigate therapeutic effects of rivet fixation of the dissociative semitendinosus tendon to strengthen the patellofemoral ligament for management of recurrent patellar dislocations.Methods From March 1999 to January 2008, 57 cases of recurrent patellar dislocation were treated in our department. They were 19 males and 38 females, with an average age of 24. 3 (range, 17 to 29) years.Their disease courses ranged from 1 to 4 years (average, 2.6 years) . Of them, 15 (group A) were treated with repair of the medial retinaculum and patellofemoral ligament, 19 (group B) with reconstruction of the medial patellofemoral ligament, and 23 (group C) with rivet fixation of the dissociative semitendinosus tendon to strengthen the patellofemoral ligament. All the patients were followed up in the out-patient department 12months later. Functional recovery was evaluated by the Lysholm scores and the Insall evaluation. Results There were statistical significant differences between the preoperative and postoperative Lysholm scores in the 3 groups respectively. Group C had a comparable therapeutic effect with group B( P > 0. 05) . The postoperative Lysholm score for group C was significantly higher than that for group A ( P 0. 05 ) . Conclusion For recurrent patella dislocations, rivet fixation of the dissociative semitendinosus tendon to strengthen the patellofemoral ligament can be as effective as the traditional medial patellofemoral reconstruction, but it is simpler and less invasive and may reduce the risk of patellar fracture. Key words: Patellar dislocation; Patellofemoral ligament; Reconstructive surgical procedures