Clinical outcomes of medial retinaculum plasty versus MPFL reconstruction with concomitant tibial tubercle transfer: a r
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ARTHROSCOPY AND SPORTS MEDICINE
Clinical outcomes of medial retinaculum plasty versus MPFL reconstruction with concomitant tibial tubercle transfer: a retrospective study Xunkai Feng1 · Fei Wang1 Received: 3 March 2020 / Accepted: 20 July 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To elucidate the clinical outcomes of medial retinaculum plasty versus MPFL reconstruction with concomitant tibial tubercle transfer. Methods From January 2014 to July 2018, 57 patients who underwent tibial tubercle transfer combined with medial retinaculum plasty or MPFL reconstruction were enrolled in the present study. The 57 patients were divided into two comparison groups according to the therapeutic protocol. The 25 patients in group I underwent the medial retinaculum plasty and tibial tubercle transfer. The 32 patients in group II underwent the MPFL reconstruction and tibial tubercle transfer. Clinical outcomes were assessed using the knee injury and osteoarthritis outcome score, Kujala score, congruence angle, patellar tilt angle, patellar lateral shift, tibial tuberosity–trochlear groove distance and Caton–Deschamps Index. The clinical outcomes were compared between the two groups preoperatively and at the time of the last follow-up. Results Significant improvement was seen in both groups postoperatively (P 0.05). Conclusion The combined medial retinaculum plasty and tibial tubercle transfer achieved similar clinical outcomes versus the MPFL reconstruction with concomitant TTT. This therapeutic protocol was a good option in treatment of patellar dislocation with increased TT–TG distance or patella alta. Keywords Patellar dislocation · Medial retinaculum plasty · MPFL reconstruction · Tibial tubercle transfer
Introduction Patellar dislocation is a common knee disease for young and active patients [1]. The etiology of patellar dislocation is multifactorial, but it could be grouped broadly and classified to bony or soft-tissue abnormalities [2, 3]. Biomechanical studies have proved that the medial patellofemoral ligament (MPFL) is the main medial soft-tissue static stabilizer of the knee joint, which provides 53–60% of restraining force to prevent the lateral patellar shift [4, 5]. And approximately * Fei Wang [email protected] Xunkai Feng [email protected] 1
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, China
94% of patients with patellar dislocation had an accompanying traumatic disruption of the MPFL [6]. Therefore, numerous techniques have been developed to restore the function of the MPFL and achieved good clinical outcomes, such as medial capsule reefing (MCR) [7], medial retinaculum plasty (MRP) [8], and MPFL reconstruction [9]. The osseous abnormalities have been well studied, such as trochlear dysplasia, patella alta, patellar tilt, and increased tibial tubercle to trochlear groove (TT–TG) distance [10, 11]. Patella alta and increased TT–TG distance are important factors in patellar dislocation, patellar maltr
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