Single-tunnel and double-tunnel medial patellofemoral ligament reconstructions have similar clinical, radiological and f
- PDF / 1,058,067 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 113 Downloads / 190 Views
KNEE
Single‑tunnel and double‑tunnel medial patellofemoral ligament reconstructions have similar clinical, radiological and functional results Niyazi Ercan1 · Ramazan Akmese2 · Burak Ulusoy3 Received: 23 January 2020 / Accepted: 28 August 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract Purpose The aim of the present study was to evaluate the clinical, radiological and functional results of patients underwent single-tunnel (ST) and double-tunnel (DT) medial patellofemoral ligament(MPFL) reconstructions with hamstring autograft following recurrent patella dislocation prospectively in a single institution. Methods From 2013 to 2017, 80 patients with symptomatic recurrent patellar dislocation or instability were randomly divided into 2 groups for MPFL reconstruction with ST technique or DT technique and evaluated prospectively. In the ST group, there were 20 male and 20 female with a median follow-up of 46.5 months (range 24–74). The median age was 15 years (range 10–28). In the DT group, there were 18 male and 22 female with a median follow-up of 40 months (range 24–74). The median age was 19 years (range 14–29). Clinical scores (Kujala score, Lysholm score, Tegner score and IKDC score) and radiological measurements (congruence angle and patellar tilt angle) of the patients were evaluated preoperatively and at postoperative 24th month. Isokinetic dynamometric tests were performed at postoperative 24th month and the difference between the operated leg and the non-operated leg was found as a percentage deficit. Results There were no postoperative complications, redislocation or subluxation in any patient. Kujala, Lysholm, Tegner and IKDC scores were better and statistically significant postoperatively in both groups (p 20° in females and > 17° in males, (3) greater trochlear angle > 145°, tuberositas tibia- trochlear groove (TT–TG) distance ≥ 20 mm, (5) patella alta (Insall-Salvati index > 1.2), (6) concomitant other ligament injuries. To ensure homogeneity of the groups, 33 patients who met these criteria and therefore required distal alignment corrective surgical procedures were excluded from the study.
Surgical technique All the operations were performed by a single surgeon. With the patient in a supine position, prophylactic antibiotic was administered then a tourniquet was applied to the thigh. The leg was stained and draped in standard surgical manner. The patient was examined under anesthesia to confirm the diagnosis and to evaluate the degree of instability.
Knee Surgery, Sports Traumatology, Arthroscopy
Lateral retinacular release was not performed to any patient. Diagnostic arthroscopy was performed and associated intraarticular injuries were recorded. During arthroscopy, the position of the patella relative to the trochlea was evaluated, while the knee was fully extended. If the patella did not overlap the trochlea (
Data Loading...
