Clinical Study Of Arthroscopy And MPFL Reconstruction In The Treatment Of Recurrent Patella Dislocation With TT-TG Distance Abnormalities

Objective: This dissertation is aimed at investigating the efficacy of adopting arthroscopic reconstruction of medial patellofemoral ligament(MPFL)to treat recurrent patellar dislocation due to abnormal distance between tibial tubercle and femoral tackle(TT-TG).Methods: From October 2015 to December 2017,the number of patients treated by concurrent surgery for recurrent patella dislocation in our department was 40(10 males and 30 female,aged 17 to 42,average age 24).Before surgery,the distance between the TT-TG of the ipsilateral knee joint was measured as 15 mm to 20 mm.The arthroscopic MPFL reconstructive surgeries were performed by the same surgeon when the patients were guided by the same rehabilitation exercise program later.Moreover,40 patients were followed up after surgery in the next 4 weeks,3 months,6 months and 1 year respectively.Data of fear tests,patella extrapolation experiments,Lysholm knee scores,and IKDC knee subjective functional scores were collected from these patients before and after operation.The data of tibial angle of inclination(PTA)were used to evaluate the efficacy of arthroscopic MPFL reconstruction when TT-TG was less than 20 mm.Results: For these 40 patients,there was no recurrent dislocation of the patella within 12 months after operation,with the tibial moving well.The results of their phobia experiments and tibial extrapolation experiments were both negative while the knee moved well without swelling and pains.After operation,the Lysholm knee score increased from 43.03±6.12 to 93.90±1.95,with the IKDC score increasing from 47.03±3.37 to 90.23±2.28.Furthermore,the PTA angle decreased from 22.15±1.62° to 12.55±0.81°,whose difference had a statistical significance(P<0.05)compared with original surgery.Conclusions: For these 40 patients with recurrent dislocation of the patella,arthroscopic MPFL reconstruction could achieve good surgical outcomes,as well as patients' high satisfaction after follow-up.For patients with abnormal TT-TG spacing(15mm?TT-TG value <20mm),arthroscopic MPFL reconstruction could also achieve satisfactory results in short term,but long-term efficacy needed further follow-up investigation.