Treatment Of Patella Subluxation Through Arthroscopic Patellar Retinaculum Adjustment And Fulkerson Osteotomy

Objective: To introduce the way of arthroscopic patellar retinaculum adjustment andFulkerson osteotomy, and to study its clinical results.Methods: since 2006 year, 10 cases of patellar subluxation have been treated by modifiedFulkerson tibial tubercle anteromedial transfer, and arthroscopic patellar retinaculumadjustment including the medial retinaculum plication and lateral retinaculum releasing.Before and after surgery 8th week、12th week、24th week a history was recorded and aphysical examination was done, and the Lysholm knee score, Tegner sport level wererecorded. They were also examined using roentgenograms or computed tomography scansof the patellofemoral joint that were made with the knee in 30 degrees of flexion, measuredthe patella-femur congruence angle(CA)、lateral patellofemoral angle(LPA)、the patellar tiltangle(PTA)、lateral patellar displacement(LPD)before and after suugery.Result: There were no recurrence at the last follow-up. The Lysholm knee score were59.00±13.37 and 92.14±5.15 (P＜0.05) before and after surgery respectively. The sportability improved in all cases. The Tegner sport level was 2.00±1.49 and 3.30±0.48 (P＜0.05)respectively before and after surgery. X～ray examination showed that, patella-femurcongruence angle(CA) were 21.10°±5.61°and -1.70°±7.41°(p＜0.05); the patellar tiltangle(PTA) were -4.50°±6.45°and 11.6°±2.27°(p＜0.05) and the lateral patellardisplacement(LPD) were 5.29mm±3.14mm and 0.20mm±1.32mm (P＜0.05) before andafter surgery respectively。Conclusion: It is effective to treat patellar subluxation by way of arthroscopic patellarretinaculum adjustment and Fulkerson osteotomy, the operation is aimed to alleviatesymptoms, and restore knee function to the greaest extent.