Comparative Clinical Study On Two Operation Methods For The Treatment Of Recurrent Patella Dislocation In Adolescents Based On The Theory Of "Paying Equal Attention To Sinew And Bone"

Objective: To compare the clinical efficacy of medial patellofemoral ligament reconstruction and medial retinaculum plication in the treatment of recurrent patella dislocation in adolescents based on the theory of "paying equal attention to sinew and bone".Methods: The retrospective analysis was conducted on the clinical efficacy of adolescent patients with recurrent patella dislocation treated in the Affiliated Hospital of Shandong University of TCM from September 2015 to March 2020.20 patients(20 knees)treated with the medial patellofemoral ligament reconstruction with the assistance of the arthroscope were selected as the observation group.20 patients(20 knees)treated with the medial retinaculum plication with the assistance of the arthroscope were selected as the control group.The average follow-up time was(14.36±2.34)months.The physical examination,imaging changes,IKDC subjective knee score(international knee documentation committee subjective knee evaluation form,International Knee Documentation Committee),Lysholm score,Kujala score changes were recorded during the follow-up period of the two groups of adolescent patients.SPSS22.0 was adopted for statistical analysis.Results: The physical examination(including patella fear test,patella extrapolation test and patella tilt test)of the two groups at 6 months after operation showed improved results compared with that before operation.At the last follow-up,the results of three knee scores(IKDC subjective knee score,Lysholm score and Kujala score)showed that the scores of the two groups were significantly improved compared with those before operation.There was no significant difference in the positive rate of physical examination(including patella fear test,patella extrapolation test and patella tilt test)between the two groups at 6 months after operation.At the last follow-up,the three knee scores in the observation group were better than those in the control group,and there was a statistical difference between the two groups(p < 0.05).After operation,the patellofemoral index in the observation group was better than that of the control group,and the results were statistically different(p<0.05).The patella inclination angle in the observation group was significantly better than that of the control group,and the difference was statistically significant(p<0.01).Conclusion: Both medial patellofemoral ligament reconstruction and medial retinaculum plication under the arthroscope are effective fixation methods for recurrent patella dislocation in adolescents,and the medial patellofemoral ligament reconstruction can achieve more reliable efficacy.