Lateral retinaculum patellae solution and medial patellofemoral ligament reconstruction using the semitendinosus tendon free grafted for the treatment of recurrent dislocation of the patella
- VernacularTitle:自体半腱肌腱游离移植重建内侧支持带治疗复发性髌骨脱位
- Author:
Yujie LIU
;
Jing XUE
;
Mi ZHOU
- Publication Type:Journal Article
- Keywords:
Arthroscopy;
Patellar dislocation;
Knee joint
- From:
Chinese Journal of Orthopaedics
2001;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the outcomes of arthroscopically lateral retinaculum patellae release and medial patellofemoral ligament reconstruction using the semitendinosus tendon autograft for the treatment of habitual or recurrent dislocation of the patella. Methods 18 cases of recurrent dislocation of the patella were included in this group, among which there were 6 males and 12 females. The average age was 20 years old(range from 17 to 24 years). Arthroscopic investigation found tensed lateral retinaculum patellae and damaged cartilage at patellar medial margin and femoral lateral condyle. There were 6 cases of Ⅱdegree cartilage injuries, 5 cases of Ⅲ degrees injuries, and 7 cases of Ⅳ degree injuries caused by patellofemoral joint impact. For cases of Ⅳ degree injuries, the damaged cartilage was shaved and microfractured. For cases of Ⅱ or Ⅲ degree injuries, radiofrequency system was used for debridement. After the lateral retinaculum patellae was extensively released, semitendinosus tendon autograft was used to reconstruct the medial patellofemoral ligament. The knee joint was flexed and extended. Patella's dynamic motion, the tension of the tendon and relationship between the femoral trochlea and patellar bone were arthroscopically observed. Interface screw was used to fix the tendon ends within the bone tunnel on condylus medialis femoris. Results All patients were followed up for 9 to 19 months averaging 13 months. No patellar dislocation occurred postoperatively. Apprehensive test, patella tilt test were negative; and Apley test were negative in 16 patients and positive in 2 patients. One case of inferior pole of patella fractured. Axial view of X-ray and MR images of patella showed 15 cases regained normal anatomical relation of patellofemoral joint. 3 cases had mild semi-dislocation. Lysholm's score averaging (78.0?4.5) points preoperatively and (94.0?3.5) points postoperatively. Conclusion Lateral retinaculum patellae solution and medial part reconstruction under arthroscope can effectively cure recurrent subluxation of the patella and improve knee joint function.
