2017 ISAKOS Biennial Congress IFOSMA ePoster #5037

 

"The improved single beam of tendon technology of Medial patellofemoral ligament reconstruction" treatment of recurrent patellar dislocation

Wenxiao Jiang, Bachelor, Qingdao, Shandong CHINA
Yijun Zhang, MD, Qing Dao, Shandong CHINA

Qilu Hospital of Shandong University (Qingdao), qingdao, shandong, china

FDA Status Not Applicable

Summary

Through the study of the case, we think that "The improved single beam of tendon technology of Medial patellofemoral ligament reconstruction" treatment of recurrent patellar: joint trauma is small, can do early functional exercise, functional recovery is good, early clinical efficacy is satisfactory, it is worth to widely used in clinical practice.

Abstract

Purpose:The curative effect analysis of "The improved single beam of tendon technology of Medial patellofemoral ligament reconstruction" for the treatment of recurrent patellar dislocation under arthroscopy surveillance.
Method:Thirty-six patients (38 patellas) with recurrent patellar dislocation hospitalized in our hospital between December 2013 and January 2016 were included as the subjects in the study (12 males, 24 females). The preoperative apprehension test for patella was positive in all patients. All patients underwent the knee arthroscopic examination to confirm the diagnosis. The autogenous semitendinosus was harvested,and surgery by “the improved single beam of tendon technology of Medial patellofemoral ligament reconstruction”. All patients did not move in tibial tubercle. Under arthroscopy surveillance, 5 cases make the lateral retinaculum release. To compare the adapter angle of patellar and incidence of patellar fractures of preoperative and postoperative. The effect was evaluated by International Knee Documentation Committee (IKDC) knee function subjective scoring and Lysholm knee function scoring. Seach the trajectory of patellofemoral joint,and degree of injury of patellofemoral articular cartilage.Mike a hole in femoral Saddle area, fixed with a squeeze nail. The patella bone is assisted by ACL point-to-point guide, application of 3.5mm Kirschner wire in the inner edge of the patella oblique distal, from the patella transverse, longitudinal axis 1/2 cortical piercing,make a bone groove at the midpoint of the inner edge of the patella,reinforcement by one anchor with tail. Pull VMO to the distal and lateral covering the medial part of the patella, sutured periosteum and soft tissue to further strengthen,make improved single beam reconstruction. Adjust the tension of the transplanted tendon under arthroscopy to make the patellofemoral movement trajectory back to normal. Conduct a rehabilitation exercise as planned after reconstruction.
Result:All patients were followed up for 6-24 months, an average of 15 months, all patients after the fear test was negative, no longer dislocation. Preoperative patellofemoral fit angle was (23±8)°,and the postoperative improvement was - (7 ± 2) °, the difference was statistically significant (P <0.05). Preoperative IKDC knee functional score and Lysholy knee function scores were (42 ± 4) and (65.6 ± 5.2),at the last follow-up, the subjective score of knee function and the Lysholy knee function score were (89.25 ± 3.26) and (95.36 ± 3.52).There were significant differences between the two groups before and after operation (P <0.05). No patella fracture.
Conclusion:Advantages of "The improved single beam of tendon technology of Medial patellofemoral ligament reconstruction" treatment of recurrent patellar dislocation: joint trauma is small, can do early functional exercise, functional recovery is good. Both to restore the ankium patellar patellar ligament anatomy, without affecting the tendon bone healing, and reduce the incidence of postoperative patellar fracture, early clinical efficacy is satisfactory, it is worth to widely used in clinical practice.