Combining Tibial Tubercle Revolving-anteromedia Displacement With Patellofemoral Ligament Adjustment For Treatment Of Patellofemoral Instability

Objective To investigate the clinical efficacy of tibial tubercle revolving-anteromedia displacement with patellofemoral ligament adjustment to treat patellofemoral instability. Offer a effective refer of patellofemoral instability surgery treatment.Methods 53 patients(62 knees) who were comfirmed to be patellofemoral instability underwent lateral patellofemoral ligament releasing and medial petellofemoral ligament reefing with tibial tubercle revolving-anteromedia displacement. 50 patients (58 knees) followed up and mean period was 38.16 months. Before and after surgery,patients were measured Q angle and assessed using the Kujala patellofemoral score and the Lysholm 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 opposition of patellofemoral joint in 36 patients (40 knees),including:CA,LPA,PE,LS,PTA,TA,TTTD.Results The Q angle was 24.09±3.25°preoperatively and 14.16±3.08°postoperatively; the Kujala score was 52.47±15.19 preoperatively and 81.93±9.31 postoperatively; the Lysholm score was 54.34±13.30 preoperatively and 82.16±9.02 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,PE,LS,PTA,TA,TTTD were all changed significantly.Conclusion This surgery could rectify thoroughly the maltracking of patellofemoral joint,relieve patellofemoral pain,improve patellofemoral joint function. This technique is an effective surgery for patellofemoral instability.