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Effects of Lateral Patellar Retinaculum Release for Recurrent Patella Dislocation: A Prospective Study
International Journal of General Medicine ( IF 2.3 ) Pub Date : 2021-09-10 , DOI: 10.2147/ijgm.s329026 Xing-Liang Wang 1 , Chao Peng 2 , You-Wei Tu 2 , Yun-Peng Liu 2 , Wei Zhang 2 , Yan Zhang 2 , Guo-Jun Hua 3
International Journal of General Medicine ( IF 2.3 ) Pub Date : 2021-09-10 , DOI: 10.2147/ijgm.s329026 Xing-Liang Wang 1 , Chao Peng 2 , You-Wei Tu 2 , Yun-Peng Liu 2 , Wei Zhang 2 , Yan Zhang 2 , Guo-Jun Hua 3
Affiliation
Purpose: Recurrent patellar dislocation (RPD) is the most common complication of patellar instability and the medial patellofemoral ligament (MPFL) reconstruction has become its reference treatment. Lateral patellar retinaculum (LPR) release used to be performed in association with MPFL reconstruction. The aim of this study was to investigate the added values of MPFL reconstruction plus LPR release for RPD.
Methods: After Institutional Review Board approval, RPD patients from October 2014 to April 2019 were randomly assigned into two groups (isolated MPFL reconstruction [Group I] and MPFL reconstruction plus LPR release [Group II]) and prospectively assessed until 12 months after surgery. Knee joints with flexion of 20° were scanned by a 64-row CT scanner. Congruence angle (CA), patella tilt angle (PTA), lateral patellofemoral angle (LPFA), tibial tuberosity-trochlear groove distance and patellar tilt with the quadriceps relaxed and contracted were measured. Knee function was assessed by Lysholm knee score and International Knee Documentation Committee (IKDC) score. Patients were followed up for at least 12 months.
Results: A total of 87 RPD patients (45 for Group I and 42 for Group II) were selected in this study. Preoperative clinical characteristics were not significantly different across groups. No serious complications were noted in either group. It was statistically insignificant between the two group patients in terms of postoperative patella associated measurements (P > 0.05 for all). The Lysholm score and IKDC score of Group I (84.5 ± 7.1 and 87.9 ± 7.2) were significantly less than that of Group II (89.7 ± 8.7 and 93.1 ± 7.7), which indicated the better knee function of Group II.
Conclusion: LPR release plus MPFL reconstruction provides additional benefits compared with isolated MPFL reconstruction in knee function. A combination of surgical treatments for RPD should be recommended.
Keywords: recurrent patella dislocation, medial patellofemoral ligament reconstruction, lateral patellar retinaculum release, prospective, combination treatment
中文翻译：
外侧髌骨视网膜释放对复发性髌骨脱位的影响：一项前瞻性研究
目的：复发性髌骨脱位（RPD）是髌骨不稳定最常见的并发症，内侧髌股韧带（MPFL）重建已成为其参考治疗方法。外侧髌骨支持带 (LPR) 松解曾经与 MPFL 重建相关联。本研究的目的是研究 MPFL 重建加 LPR 释放对 RPD 的附加价值。
方法：经机构审查委员会批准后，将 2014 年 10 月至 2019 年 4 月的 RPD 患者随机分为两组（隔离 MPFL 重建 [第一组] 和 MPFL 重建加 LPR 释放 [第二组]）并进行前瞻性评估，直至术后 12 个月。膝关节屈曲 20° 由 64 排 CT 扫描仪扫描。测量股四头肌放松和收缩时的全合角（CA）、髌骨倾斜角（PTA）、外侧髌股角（LPFA）、胫骨粗隆-滑车沟距离和髌骨倾斜度。膝关节功能通过 Lysholm 膝关节评分和国际膝关节文献委员会 (IKDC) 评分进行评估。对患者进行至少 12 个月的随访。
结果：本研究共选择了 87 名 RPD 患者（第一组 45 名，第二组 42 名）。各组术前临床特征无显着差异。两组均未发现严重并发症。两组患者术后髌骨相关测量值差异无统计学意义（均P>0.05）。I组Lysholm评分和IKDC评分（84.5±7.1和87.9±7.2）明显低于II组（89.7±8.7和93.1±7.7），表明II组膝关节功能更好。
结论：与孤立的 MPFL 重建相比，LPR 释放加 MPFL 重建在膝关节功能方面提供了额外的好处。应推荐 RPD 的手术治疗组合。
关键词：复发性髌骨脱位, 内侧髌股韧带重建, 外侧髌骨支持带松解术, 前瞻性, 联合治疗
更新日期：2021-09-10
Methods: After Institutional Review Board approval, RPD patients from October 2014 to April 2019 were randomly assigned into two groups (isolated MPFL reconstruction [Group I] and MPFL reconstruction plus LPR release [Group II]) and prospectively assessed until 12 months after surgery. Knee joints with flexion of 20° were scanned by a 64-row CT scanner. Congruence angle (CA), patella tilt angle (PTA), lateral patellofemoral angle (LPFA), tibial tuberosity-trochlear groove distance and patellar tilt with the quadriceps relaxed and contracted were measured. Knee function was assessed by Lysholm knee score and International Knee Documentation Committee (IKDC) score. Patients were followed up for at least 12 months.
Results: A total of 87 RPD patients (45 for Group I and 42 for Group II) were selected in this study. Preoperative clinical characteristics were not significantly different across groups. No serious complications were noted in either group. It was statistically insignificant between the two group patients in terms of postoperative patella associated measurements (P > 0.05 for all). The Lysholm score and IKDC score of Group I (84.5 ± 7.1 and 87.9 ± 7.2) were significantly less than that of Group II (89.7 ± 8.7 and 93.1 ± 7.7), which indicated the better knee function of Group II.
Conclusion: LPR release plus MPFL reconstruction provides additional benefits compared with isolated MPFL reconstruction in knee function. A combination of surgical treatments for RPD should be recommended.
Keywords: recurrent patella dislocation, medial patellofemoral ligament reconstruction, lateral patellar retinaculum release, prospective, combination treatment
中文翻译：
外侧髌骨视网膜释放对复发性髌骨脱位的影响：一项前瞻性研究
目的：复发性髌骨脱位（RPD）是髌骨不稳定最常见的并发症，内侧髌股韧带（MPFL）重建已成为其参考治疗方法。外侧髌骨支持带 (LPR) 松解曾经与 MPFL 重建相关联。本研究的目的是研究 MPFL 重建加 LPR 释放对 RPD 的附加价值。
方法：经机构审查委员会批准后，将 2014 年 10 月至 2019 年 4 月的 RPD 患者随机分为两组（隔离 MPFL 重建 [第一组] 和 MPFL 重建加 LPR 释放 [第二组]）并进行前瞻性评估，直至术后 12 个月。膝关节屈曲 20° 由 64 排 CT 扫描仪扫描。测量股四头肌放松和收缩时的全合角（CA）、髌骨倾斜角（PTA）、外侧髌股角（LPFA）、胫骨粗隆-滑车沟距离和髌骨倾斜度。膝关节功能通过 Lysholm 膝关节评分和国际膝关节文献委员会 (IKDC) 评分进行评估。对患者进行至少 12 个月的随访。
结果：本研究共选择了 87 名 RPD 患者（第一组 45 名，第二组 42 名）。各组术前临床特征无显着差异。两组均未发现严重并发症。两组患者术后髌骨相关测量值差异无统计学意义（均P>0.05）。I组Lysholm评分和IKDC评分（84.5±7.1和87.9±7.2）明显低于II组（89.7±8.7和93.1±7.7），表明II组膝关节功能更好。
结论：与孤立的 MPFL 重建相比，LPR 释放加 MPFL 重建在膝关节功能方面提供了额外的好处。应推荐 RPD 的手术治疗组合。
关键词：复发性髌骨脱位, 内侧髌股韧带重建, 外侧髌骨支持带松解术, 前瞻性, 联合治疗
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