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Evaluation of different surgical methods in treating recurrent patella dislocation after three-dimensional
Hao Du1, Xiao-Xiao Tian2, Fa-Qi Guo1
1Department of Orthopaedics, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, China.
International Orthopaedics
|July 14, 2017
Summary
The study compared three surgical techniques for recurrent patella dislocation. Medial patellofemoral ligament reconstruction combined with lateral patellar retinaculum release yielded the best joint congruence and knee function outcomes.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- Recurrent patella dislocation (RPD) is a common complication of patellar instability.
- Optimal surgical treatment for RPD remains an area of active investigation.
- Comparing different surgical techniques is crucial for improving patient outcomes.
Purpose of the Study:
- To compare the effectiveness of three distinct surgical techniques for treating recurrent patella dislocation.
- To evaluate the impact of these techniques on patellofemoral joint congruence and knee function.
- To utilize 3D CT reconstruction for objective assessment of surgical outcomes.
Main Methods:
- Sixty-eight patients with RPD were randomized into three groups: MPFL reconstruction with MPR plication, LPR release with MPR plication, or MPFL reconstruction with LPR release.
- 3D CT scans of knee joints at 20° flexion were used for reconstruction.
- Measurements included congruence angle (CA), patellar tilt angle (PTA), lateral patellofemoral angle (LPFA), and lateral patellofemoral articular surface congruence.
- Knee function was assessed using Lysholm, Kujala, and IKDC scores.
Main Results:
- All three surgical techniques normalized post-operative CA, PTA, and LPFA without significant differences.
- The MPFL reconstruction and LPR release group demonstrated superior lateral patellofemoral articular surface congruence.
- The LPR release and MPR plication group showed the lowest functional scores (Lysholm, Kujala, IKDC).
Conclusions:
- MPFL reconstruction combined with LPR release offers the best clinical outcomes for RPD.
- This technique improves joint congruence and enhances overall knee function compared to other methods.
- 3D CT reconstruction provides valuable objective data for evaluating surgical success in RPD treatment.