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 < 0.05). However, there was no statistically significant difference between the groups (n.s.). The congruence angle and patellar tilt angle were found to be returned to normal values postoperatively, but there was no statistically significant difference between the groups (n.s.). There was no statistically significant difference between the two groups in isokinetic dynamometric tests performed as 60° flexion, 60° extension, 180° flexion and 180° extension (n.s.).

Conclusion

The present study is the first that compared the clinical, radiological and functional results of the ST and DT techniques to date. Regardless of the number of the tunnels, similar results were obtained in ST and DT reconstruction using transpatellar tunnel technique.

Level of evidence

Level I.

中文翻译：

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单隧道和双隧道内侧pa股韧带重建具有相似的临床，放射学和功能结果。

目的

本研究的目的是评估单次复发single骨脱位后行绳肌自体移植的单-骨（ST）和双-骨（DT）内侧pa股韧带（MPFL）重建患者的临床，放射学和功能结果机构。

方法

2013年至2017年，将80例有症状的复发性pa骨脱位或不稳患者随机分为2组，采用ST技术或DT技术进行MPFL重建，并进行前瞻性评估。在ST组中，男性20例，女性20例，平均随访46.5个月（范围24-74）。中位年龄为15岁（范围为10-28）。在DT组中，男性18例，女性22例，中位随访时间为40个月（范围24-74）。中位年龄为19岁（范围为14-29）。在术前和术后24个月评估患者的临床评分（Kujala评分，Lysholm评分，Tegner评分和IKDC评分）和放射学测量结果（一致角和pa骨倾斜角）。

结果

任何患者均无术后并发症，再移位或半脱位。两组的Kujala，Lysholm，Tegner和IKDC评分均更好，且在统计学上具有统计学意义（p <0.05）。但是，各组之间的差异无统计学意义（ns）。术后发现全角和pa骨倾斜角恢复到正常值，但各组之间的差异无统计学意义（ns）。两组在进行60°屈曲，60°伸展，180°屈曲和180°伸展（ns）进行的等速测力试验中，两组之间在统计学上没有显着差异。

结论

本研究是第一个比较迄今为止ST和DT技术的临床，放射学和功能结果的研究。无论隧道的数量如何，使用using骨隧道技术在ST和DT重建中均获得了相似的结果。

证据水平

一级