Summary

Lateral release of the patella with lengthened incision open surgery versus arthroscopic with small incision in osteofascial medial patellofemoral ligament reconstruction for recurrent patellar dislocation

Abstract

Purpose

To evaluate and compare clinical outcomes between lateral release of the patella with lengthened incision open surgery and arthroscopic with small incision in osteofascial medial patellofemoral ligament reconstruction for recurrent patellar dislocation.

Methods

Fifty-one patients received surgery who were diagnosed as suffering malfunctional patellofemoral joint from May 2012 to March 2014 in our institution. Twenty-eight were treated with lateral release of the patella with lengthened incision open surgery in osteofascial medial patellofemoral ligament reconstruction and twenty-three patients received arthroscopic with small incision in osteofascial medial patellofemoral ligament reconstruction. All patients received clinical physical examination, imaging examination and knee joint function score both preoperative and postoperative. The stability of the patella was examined by physical examination. The patellar lateral shift ratio, patellar tilt angle, sulcus angle and TT-TG were measured on CT scans. The function of the knee was evaluated by the subjective questionnaire, include Kujala score and Lysholm score. SPSS software was used for statistics analysis.

Results

The follow-up time exceed 33 months. The patients’ basic clinical data, included age and gender, showed no significance. Two patients in the arthroscopic group suffered transient patellar dislocation. Postoperative patellar lateral shift ratio and patellar tilt angle returned to normal of both groups, but no significant difference was found of sulcus angle and TT-TG compared with preoperative. All two groups’ postoperative Kujala score and Lysholm score were superior to preoperative. However, there was no significant difference between two groups, included imaging examination and knee joint function score.

Conclusions

Both two surgical procedures which apply to recurrent dislocation of patella except result from critical bone structure dysplasia can improve patellofemoral joint relationship and patellar stability obviously. Meanwhile, arthroscopic lateral release of the patella with small incision is essential and it shows advantages of less injury and quick rehabilitation. Open surgery has no significant superiority in imaging examination and knee joint function score.