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Imaging findings and clinical function after combined surgery for recurrent patella dislocation: a comparative study.

Haiyun Xu1, Fangfang Yan1, Ji Shen2

  • 1Department of Radiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Quantitative Imaging in Medicine and Surgery
|January 9, 2023
PubMed
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This study compared two surgical techniques for recurrent patella dislocation (RPD). Medial patellofemoral ligament (MPFL) reconstruction with lateral retinacular release (LRR) alone or with tibial tuberosity transfer (TTT) showed satisfactory outcomes. TTT may not be needed for patients with a TT-TG distance over 15 mm.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Radiology

Background:

  • Limited research exists on imaging outcomes after combined surgeries for recurrent patella dislocation (RPD).
  • This study retrospectively compares imaging and clinical results of two combined surgical techniques for RPD.

Purpose of the Study:

  • To compare imaging and clinical outcomes of MPFL reconstruction with LRR versus MPFL reconstruction with LRR and TTT for RPD.
  • To evaluate the necessity of TTT in RPD patients with a TT-TG distance greater than 15 mm.

Main Methods:

  • Retrospective study of patients undergoing combined surgery for RPD (2008-2019).
  • Group A: MPFL reconstruction + LRR. Group B: MPFL reconstruction + LRR + TTT.
  • Subgroup A*: Group A patients with TT-TG > 15 mm.
Keywords:
Recurrent patella dislocationimaging measurement valueknee function score

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  • Assessed imaging parameters (CA, PTA, LPA, LPD, TT-TG, ISI, Dejour type) and knee function (Kujala score).
  • Short-term (1-2 years) and mid-term (over 5 years for Group B) follow-ups.

    • Main Results:

    • Both surgical groups showed satisfactory patellofemoral joint alteration and improved knee function.
    • Group B showed increased PTA and decreased LPD at mid-term follow-up compared to short-term.
    • Severe trochlear dysplasia correlated with lower mid-term Kujala scores in Group B.
    • Group B had lower short-term TT-TG and ISI, but higher Kujala scores than Group A.
    • Subgroup A* showed higher CA, LPD, ISI, TT-TG, and Kujala scores than Group B at short-term follow-up.

    Conclusions:

    • Both combined surgical techniques for RPD are effective in improving knee function.
    • Tibial tuberosity transfer (TTT) may not be essential for RPD patients with a TT-TG distance exceeding 15 mm.