Clinical efficacy of arthroscopic medial patellofemoral complex reconstruction for recurrent patellar dislocation with high-grade trochlear dysplasia.
- Author:
Fengyi HU
1
;
Qingyang MENG
1
;
Nayun CHEN
1
;
Jianing WANG
1
;
Zhenlong LIU
1
;
Yong MA
1
;
Yuping YANG
1
;
Xi GONG
1
;
Cheng WANG
1
;
Ping LIU
1
;
Weili SHI
1
Author Information
1. Department of Sports Medicine, Peking University Third Hospital; Institute of Sports Medicine of Peking University; Beijing Key Laboratory of Sports Injuries, Beijing 100191, China.
- Publication Type:Journal Article
- Keywords:
Dejour classification;
Femoral trochlear dysplasia;
Medial patellofemoral complex reconstruction;
Patellar dislocation;
Recurrence
- MeSH:
Humans;
Patellar Dislocation/surgery*;
Male;
Female;
Adult;
Arthroscopy/methods*;
Retrospective Studies;
Adolescent;
Young Adult;
Patellofemoral Joint/surgery*;
Recurrence;
Plastic Surgery Procedures/methods*;
Patella/surgery*;
Treatment Outcome
- From:
Journal of Peking University(Health Sciences)
2025;57(5):947-955
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the midterm clinical efficacy of medial patellofemoral complex (MPFC) reconstruction for recurrent patellar dislocation with high-grade trochlear dysplasia.
METHODS:A retrospective analysis was carried out among adult patients who underwent arthroscopically assisted MPFC reconstruction between January 2014 and December 2020. Dejour classification was evaluated to grade trochlear dysplasia; tibial tubercle-trochlear groove (TT-TG) distance and Insall-Salvati index were measured. Preoperative and postoperative patient-reported outcome measures (PROMs) were compared, including International Knee Documentation Committee (IKDC) score, Kujala score, Lysholm score and Tegner score. Information regarding returning-to-sport rate, re-instability events and complications was collected. Patellar tilt (PT), lateral patellar displacement (LPD) and bisect offset (BSO) ratio were measured based on axial computed tomography before and after surgery to assess the patellofemoral congruence.
RESULTS:A total of 46 MPFC reconstructions in 43 patients were enrolled, including 16 male and 27 female. Mean age at surgery was (22.2±7.6) years (range: 14-44 years). Mean follow-up was (49.9±22.6) months (range: 18-102 months). The percentages of Dejour B, C and D dysplasia were 37.0% (17/46), 43.5% (20/46), and 19.6% (9/46), respectively. Mean Insall-Salvati index was 1.2±0.2 (range: 0.85-1.44), and mean TT-TG distance was (19.6±3.5) mm (range: 10.6-28.7 mm). At latest follow-up, there were significant improvements in all PROMs (P < 0.001): IKDC score, from 56.3±15.1 to 86.2±8.1; Kujala score, from 58.9±15.6 to 92.6±5.4; Lysholm score, from 63.7±15.0 to 94.0±5.7; Tegner score, from 3.1±1.4 to 4.7±1.4, and there were no significant differences in the improvements of the scores between the patients with Dejour B, C and D dysplasia. Overall, ninety percent of the patients returned to their preoperative sports level. One patient reported a postoperative subluxation, while no cases of infection, limited range of motion or patella fracture were observed. PT, LPD and BSO ratio were all significant altered (P < 0.001) after MPFC reconstruction.
CONCLUSION:Arthroscopically assisted MPFC reconstruction yielded satisfactory midterm clinical results for recurrent patellar dislocation with high-grade trochlear dysplasia. No significant differences of improvements in knee function were observed among the three types of high-grade trochlear dysplasia.
