Relationship between bony tunnel and knee function in patients after patellar dislocation triple surgeries-a CT-based...

Area of Science:

• Orthopedic Surgery
• Biomedical Imaging
• Knee Biomechanics

Background:

• Patellar dislocation often requires complex surgical reconstruction, including medial patellofemoral ligament (MPFL) reconstruction, lateral retinaculum release, and tibial tubercle osteotomy.
• The precise placement and characteristics of bony tunnels created during these procedures can significantly impact knee function and patient outcomes.
• Computed tomography (CT) is a valuable tool for evaluating bony tunnel morphology and position postoperatively.

Purpose of the Study:

• To evaluate CT-based measurements of bony tunnels after triple surgeries for patellar dislocation.
• To determine the correlation between femoral tunnel position (anterior-posterior and proximal-distal) and knee function.
• To assess changes in patellar and femoral tunnel width over time and their relationship to functional outcomes.

Main Methods:

• Retrospective analysis of 66 patients (70 knees) who underwent triple patellar dislocation surgery.
• CT scans were performed within 3 days and over 1 year postoperatively to assess femoral tunnel position and tunnel width.
• Knee function was evaluated using the Kujala and Lysholm scores.

Main Results:

• A moderate correlation was found between the anterior-posterior femoral tunnel position and knee function at the final follow-up.
• Proximal-distal femoral tunnel position did not show an association with postoperative knee function.
• Significant increases in patellar and femoral tunnel width were observed over time, but this did not correlate with functional differences.

Conclusions:

• CT-based assessment reveals that anterior-posterior malposition of the femoral tunnel is linked to impaired knee function following patellar dislocation triple surgeries.
• While tunnel width increases postoperatively, it does not appear to significantly affect functional outcomes.
• Precise control of femoral tunnel placement in the anterior-posterior plane is critical for optimizing knee function after these procedures.