BACKGROUND The purpose of this study was to retrospectively analyze the clinical outcomes of patients with recurrent patellar dislocation who underwent arthroscopic medial patellofemoral ligament (MPFL) reconstruction using gracilis tendon autograft and a modified double-patellar tunnel method. We hypothesized that our modified method would provide good clinical outcomes. METHODS Patients who underwent arthroscopic MPFL reconstruction with autograft gracilis tendon and modified double-patellar tunnels technique for recurrent patellar dislocation and were followed up for a minimum of 5 years were identified, and the clinical and follow-up data were retrospectively analyzed. Preoperatively, joint hypermobility was assessed with the Beighton score. The Insall-Salvati ratio, TT-TG distance, and Q angle were measured on radiographic images. Patient-reported outcomes including the Kujala, Lysholm, and Tegner scores were collected preoperatively and postoperatively. Patient satisfaction was assessed at the end of 5 years. Complications and recurrent dislocation occurring after surgery were recorded. RESULTS A total of 79 patients (94 knees) were enrolled; of these, 13 (16.5%) were lost to follow-up. The data of 66 patients (80 knees) were available for final analysis. Mean age at surgery was 21.3 ± 7.8 years. Mean follow-up time was 66.1 ± 5.5 months (range, 60-78 months). Postoperative patient-reported outcome was not associated with Beighton score, Insall-Salvati ratio, or TT-TG distance. Q angle was negatively correlated to Kujala scores and Lysholm scores. Severity of trochlear dysplasia was not associated with postoperative patient-reported outcome. The mean Kujala score increased from 69.4 ± 7.9 to 96.1 ± 1.9, the mean Tegner score increased from 3.1 ± 1.3 to 5.9 ± 1.3, and the mean Lysholm score increased from 73.5 ± 14.6 to 95.3 ± 3.4. Two patients experienced recurrent patellar dislocation during follow-up. CONCLUSIONS MPFL reconstruction using autologous gracilis tendon under arthroscopy appears to be a reliable and safe method for treating recurrent patellar dislocation. LEVEL OF EVIDENCE Level IV.

中文翻译：

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采用关节镜下自体股薄肌腱重建内侧髌股韧带和改良双髌骨隧道技术治疗髌骨脱位：至少 5 年患者报告结果。

背景本研究的目的是回顾性分析复发性髌骨脱位患者接受关节镜下自体股薄肌腱移植和改良双髌骨隧道法重建内侧髌股韧带（MPFL）的临床结果。我们假设我们的修改方法将提供良好的临床结果。方法 筛选接受关节镜下自体股薄肌腱重建 MPFL 和改良双髌骨隧道技术治疗复发性髌骨脱位并随访至少 5 年的患者，并对临床和随访资料进行回顾性分析。术前用 Beighton 评分评估关节过度活动度。在射线照相图像上测量 Insall-Salvati 比、TT-TG 距离和 Q 角。术前和术后收集患者报告的结果，包括 Kujala、Lysholm 和 Tegner 评分。5 年后评估患者满意度。记录术后发生的并发症和复发性脱位。结果 共有 79 名患者（94 膝）入组；其中，13 例（16.5%）失访。66 名患者（80 个膝盖）的数据可供最终分析。手术时的平均年龄为 21.3 ± 7.8 岁。平均随访时间为 66.1 ± 5.5 个月（范围，60-78 个月）。术后患者报告的结果与 Beighton 评分、Insall-Salvati 比值或 TT-TG 距离无关。Q角与Kujala评分和Lysholm评分呈负相关。滑车发育不良的严重程度与术后患者报告的结果无关。Kujala 平均评分从 69.4 ± 7.9 增加到 96.1 ± 1.9，Tegner 平均评分从 3.1 ± 1.3 增加到 5.9 ± 1.3，Lysholm 平均评分从 73.5 ± 14.6 增加到 95.3 ± 3.4。两名患者在随访期间出现复发性髌骨脱位。结论 关节镜下使用自体股薄肌腱重建 MPFL 似乎是治疗复发性髌骨脱位的可靠且安全的方法。证据级别 IV 级。