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KMID : 0359420230410010011
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Korean Journal of Sports Medicine
2023 Volume.41 No. 1 p.11 ~ p.18
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Medial Patellofemoral Ligament Reconstruction Using Adjustable Tensioning under Arthroscopic Visualization Provides Satisfactory Radiographic and Clinical Outcomes
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Sohn Su-Een
Choi Jung-Yun
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Abstract
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Purpose : Recurrent patellar dislocation required a surgical reconstruction of medial patellofemoral ligament (MPFL)in many cases. During MPFL reconstruction, over-tension of medial construct altered the patellofemoral kinematicswhich may result in pain, patellofemoral joint degeneration, or graft failure. Thus, it is important to confirm appropriatetension intraoperatively. The purpose of this study was to evaluate the clinical and radiographic outcomes of MPFLreconstruction with use of an adjustable tensioning under arthroscopic direct visualization of patellofemoral joint.
Methods: This retrospective study included 11 MPFL reconstructions (nine patients) from 2013 to 2020. All the patientsreceived the same surgical procedures by a single surgeon. Final graft tension was determined after confirming patellarposition to the trochlear groove at 60° knee flexion under arthroscopic exam. Patient demographics, pre- and postoperativeradiographic results including congruence angle and Insall-Salvati ratio, and clinical outcomes were compared.
Results: The congruence angle was significantly changed from 32.8°±21.1° preoperatively to 8.4°±11.5° postoperatively(p=0.003), and the Insall-Salvati ratio was 1.16°±0.15° and 1.10°±0.13° respectively (p=0.02). Clinical scores were signi ficantly improved between pre- and postoperatively; Kujala score (33.2±18.3 to 88.8±4.7, p=0.04), Lysholm score (30.2±15to 79.0±5.2, p=0.005), and Tegner level (2.2±1.1 to 4.4±1.7, p=0.04). There was no recurrence of patellar dislocation.
Conclusion: MPFL reconstruction using adjustable tensioning under arthroscopic direct visualization could obtainsatisfactory outcomes after surgery.
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KEYWORD
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Medial patellofemoral ligament, Reconstruction, Arthroscopy, Video-assisted surgery, Treatment outcome
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