Abstract
Background To report the clinical outcomes of a longitudinal patellar tunnel technique in reconstruction of the medial patellofemoral ligament(MPFL) with anterior half of the peroneus longus tendon autograft treatment of recurrent patellar dislocation.Methods From May 2010 to January 2019, we performed MPFL reconstruction with anterior half of the peroneus longus tendon autograft by using a longitudinal patellar tunnel technique on 48 knees in 45 patients(26 female, 19 male) with the median age was 24 (17 ~ 44) years old with recurrent patellar dislocation. We made one 4. 5 mm channel from the medial upper edge of the patella to the surface (medial half) of the patella so that to introduce autograft into the medial femoral channel. The autograft was fixed with absorbable screws with the knee bent at 30°. CT and X-rays were used to assess the correction of the tibia tuberosity- trochlear groove (TT-TG) distance, patellar tilt angle, Caton-Deschamps index, femoral anteversion angle, tibial extorsion angle, and the presence or absence of knee valgus. Subjective scores, such as Kujala score and Lysholm score, were used to evaluate knee function preoperatively and postoperatively.Results No recurrence of patellar dislocation occurred in these patients during an average of 25 ± 7.6 months (range, 6 to 54 months) of follow-up. Preoperative TT-TG distance, patellar tilt angles, and Caton-Deschamps index was (18.9 ± 5.7)mm(10.2mm ~ 32.4 mm),31.5°±13.7° (20.3°~58.4°),1.1 ± 0.2 (1.0 ~ 1.5), respectively, which were corrected by (10.8 ± 4.3) mm (4.5 mm ~ 17.1 mm), 10.7°±2.6° (5.6°~15.3°), and 1.07 ± 0.06 (1.02 ~ 1.15) postoperatively(P < 0.05). 28 knees were treated with lateral release + MPFL reconstruction; 11 knees were treated with lateral release + tibial tubercle ingression + MPFL reconstruction; 9 knees were treated with lateral release + tibial tubercle ingression and depression + MPFL reconstruction. At the last follow-up, Lysholm score was (89.7 ± 2.3), which significantly improved (P < 0.05) compared with the pre-operational score of (54.4 ± 5.9); Kujala score was (91.5 ± 4.4) points, which significantly improved (P < 0.05) compared with the pre-operational score of (60.6 ± 5.8).Conclusion One patellar tunnels in reconstruction of the medial patellofemoral ligament (MPFL) with anterior half of the peroneus longus tendon autograft is a safe, effective, and economic method for recurrent patellar dislocation.
Arthroscopic anterior cruciate ligament reconstruction with semitendinosus graft versus peroneus longus tendon graft
