Treatment Of Traumatic Recurrent Dislocation Of Patellar Through Arthroscopic Reconstruction Of Medial Patellofemoral Ligament

Objective:To explore the effectiveness of arthroscopic of the medial patellofemoral ligament(MPFL) reconstruction using the tendon allograft(AT) for traumatic recurrent dislocation of patellar(RDP).Methods:The total of28cases with traumatic recurrent patellar dislocation were retrospectively analyzed from January2006to April2010in our department,including12males and16females with an average age of23years old(range from14to36).A11patients had injury history when the frist patellar dislocation and experienced patellar dislocation more than3times.The condition of patellofemoral joint and MPFL were detected with X-ray and MRI preoperatively.Inclusion criteria:Q angel<20°、femoral trochlear depth(FTD)>8.3mm、femoral trochlear angel(FTA)<130’and lateral patellofemoral angle(LPA) lateral shift distance(LSD) were measured. The surgical approach:The arthroscopic examination was undertaken before the reconstruction to observe the patellofemoral congruence and the patellar track,as well as articular cartilage.The lateral retinaculum was released by arthroscopy if it is significant taut.Dynamiced the tension of medial patellofemoral ligament under arthroscopic and reconstructed in anatomic insertion with tendon allograft.The arthroscopic examination was taken again to measure the patellofemoral congruence and the patellar track after reconstruction.All cases accepted regular rehabilitation.Results:All patients were followed up with an average of26months(range from12to36).No infection,graft rejection and rupture were observed in all cases.The patellar stability was restored in all cases.and no recurrence of patellar dislocation was found within follow-up. Lysholm and Kujala scores were used in preoperatively and postperatively. Statistically, the diference between the two scores is significant(P<0.05).The sport ability improved in all patients.Conclusion:It is an effectiveness method that the medial patellofemoral ligament(MPFL) reconstruction of arthroscopic use the tendon allograft for traumatic recurrent dislocation of patellar.