Treatment of recurrent patellar dislocation without bone deformity by autologous semitendinosus tendon and double bundles reconstruction of medial patellofemoral ligament

Abstract

Objective To evaluate the clinical efficacy of autologous semitendinosus tendon and double bundles reconstruction of medial patellofemoral ligament(MPFL) in the treatment of recurrent patellar dislocation without bone deformity. Methods The retrospective analysis was performed on the clinical data of 12 patients with recurrent patellar dislocation without bone deformities who were reconstructed by autologous semitendinosus tendon in Wuhu Hospital of Traditional Chinese Medicine from June 2015 to December 2017, including 2 males and 10 females, aged 14-46(27.75±10.14) years. All patients whose lateral patellar anchor nail fixed graft using two belt line, the femur after adjusting the tension side under arthroscopy using extrusion screw implant interface, postoperative 1, 3, 6 and 12 months follow-up, subjective evaluation of patellofemoral joint friction feeling, patellar abnormal activities, patellar extrapolation experiment and extrapolation of fear, the knee joint motion, muscle strength test. Imaging(X-ray) was used to evaluate the position of the bone tract, and Lysholm, Tegner and Kujala scores were used to evaluate the knee function before and after surgery. Results All 12 patients were successfully operated, and were followed up for 12 to 24 months, mean 13.5 months. No patella redislocation or patella dislocation were found after operation.0° and 30° bend knees a patellar extrapolation experiment and extraopolation fears were negative. The lysholm score was preoperative 66.00±4.71 and the final follow-up 92.67±3.23.Tegner score was preoperative 3.33±0.89 and the final follow-up 5.33±0.78.The subjective scores of Kujala were preoperative 53.67 ±3.23 and final follow-up 91.50±2.68, with statistically significant differences(t=16.248, 32.176, 89.350, all P values<0.01). Conclusions MPFL is a safe, effective and reliable method and can achieve satisfactory clinical result for the reconstruction of MPFL with autologous semitendinosus tendon and double beam anatomic reconstruction in patients with recurrent patrllar dislocation. Key words: Patella dislocation; Recurrent patellar dislocation; Medial patellofemoral ligament; Reconstructive surgical procedures