Clincal Research Of Medial Patellar Retinaculum Reefing And Lateral Patellar Retinaculum Releasing With Tibial Tubercle Revolving-anteromedial Displacement To Treat Patellofemoral Instability

Objective:To investigate the clincal reseach of medial patellar retinaculum reefing and lateral patellar retinaculum releasing with tibial tubercle revolving-anteromedia displacement to treat patellofemoral instability.Offer a effective refer of patellofemoral instability surgery treatment.Methods:33 patients(44knees)who were confirmed to be patellofemoral instability by symptom,medical examination and radiographic methods,underwent medial patellar retinaculum reefing and lateral patellar retinaculum releasing with tibial tubercle revolving-anteromedia displacement.30 patients(36knees)followed up and mean period was 19.17 months.Patients were assessed before and after surgery using the Kujala patellofemoral score and the knee joint daily activities score.The patellofemoral joint were examed with the knee in 0°,10°,20°,30°,40°of flexion by CT.Measured and compared the indexes which describe the apposition of patellofemoral joint in 19 patients(25knee),including:FTA,CA,LPA,LS,PE,FTD,TA,PTA,TTTDResults:The Kujala score was 53.36±15.76 preoperatively and 80.53±9.41 postoperatively; the knee joint daily activities score was 56.97±14.40 preoperatively and 79.75±9.88 postoperatively.There were statistical differences(P＜0.01)between preoperatively and postoperatively.It evidenced the patellofemoral joint function was changed significantly.The comparison of the indexes of CT exam displayed CA,LPA,LS,PE,TA,PTA,TTTD were all changed significantly(P＜0.01).Conclusion:Medial patellar retinaculum reefing and lateral patellar retinaculum releasing with tibial tubercle revolving-anteromedia displacement to treat patellofemoral instability could rectify thoroughtly the maltracking of patellofemoral joint,equilibrate the pressure of patellofemoral joint exterior and interior space,relieve patellofemoral pain,improve patellofemoral joint function.This technique is an effective surger for patellofemoral instability.