Abstract：
The optimal method for achieving proper graft tension during patellofemoral ligament reconstruction is a topic of debate. In the past, a digital tensiometer was used to simulate the knee structure, and a tension of approximately 2N was identified as suitable for restoring the patellofemoral track. However, it is unclear whether this tension level is sufficient during the actual surgery. The objective of this study was to verify the efficacy of graft tension using a digital tensiometer for medial patellofemoral ligament (MPFL) reconstruction and to conduct a mid-term follow-up.
The study enrolled 39 patients who had experienced recurrent patellar dislocation. Preoperative computed tomography scans and X-rays confirmed patellar instability, patellar tilt angle patellar congruence angle and the history of dislocation and patellar apprehension test. Knee function was evaluated using preoperative and postoperative Lysholm and Kujala scores.
The study included 39 knees, comprising 22 females and 17 males, with an average age of 21.10 ± 7.26. The patients were followed up for at least 24 months through telephone or face-to-face questionnaires. All patients had a preoperative history of ≥2 patellar dislocations, none of which were surgically treated. During surgery, all patients underwent isolated MPFL reconstruction and lateral retinacula release. The mean Kujala and Lysholm scores were 91.28 ± 4.90 and 90.67 ± 5.15, respectively. The mean PTA and PCA were 11.5 ± 2.63 and 2.38 ± 3.58, respectively. The study found that a tension of approximately 27.39 ± 5.57N (14.3-33.5N) was required to restore the patellofemoral track in patients with recurrent patellar dislocation. No patients required reoperation during the follow-up period. Overall, 36 out of 39 patients (92.31%) reported no pain when completing daily activities at the last follow-up.
In conclusion, a tension level of approximately 27.39 ± 5.57N is necessary to restore normal patellofemoral relationships during clinical practice, which indicates that using a tension of 2N is too low. The use of a tensiometer during patellofemoral ligament reconstruction is a more accurate and reliable surgical procedure for treating recurrent patellar dislocation.
The study enrolled 39 patients who had experienced recurrent patellar dislocation. Preoperative computed tomography scans and X-rays confirmed patellar instability, patellar tilt angle patellar congruence angle and the history of dislocation and patellar apprehension test. Knee function was evaluated using preoperative and postoperative Lysholm and Kujala scores.
The study included 39 knees, comprising 22 females and 17 males, with an average age of 21.10 ± 7.26. The patients were followed up for at least 24 months through telephone or face-to-face questionnaires. All patients had a preoperative history of ≥2 patellar dislocations, none of which were surgically treated. During surgery, all patients underwent isolated MPFL reconstruction and lateral retinacula release. The mean Kujala and Lysholm scores were 91.28 ± 4.90 and 90.67 ± 5.15, respectively. The mean PTA and PCA were 11.5 ± 2.63 and 2.38 ± 3.58, respectively. The study found that a tension of approximately 27.39 ± 5.57N (14.3-33.5N) was required to restore the patellofemoral track in patients with recurrent patellar dislocation. No patients required reoperation during the follow-up period. Overall, 36 out of 39 patients (92.31%) reported no pain when completing daily activities at the last follow-up.
In conclusion, a tension level of approximately 27.39 ± 5.57N is necessary to restore normal patellofemoral relationships during clinical practice, which indicates that using a tension of 2N is too low. The use of a tensiometer during patellofemoral ligament reconstruction is a more accurate and reliable surgical procedure for treating recurrent patellar dislocation.
摘要：
目的：在髌股韧带重建过程中实现适当的移植物张力的最佳方法是一个争论的话题。在过去,使用数字张力计来模拟膝盖结构，大约2N的张力被确定为适用于恢复髌股轨道。然而,目前尚不清楚在实际手术过程中这种紧张程度是否足够。本研究的目的是使用数字张力计验证移植物张力在内侧髌股韧带（MPFL）重建中的功效，并进行中期随访。
方法：该研究纳入了39例复发性髌骨脱位患者。术前计算机断层扫描和X射线证实髌骨不稳定，髌骨倾斜角髌骨全等角及脱位史和髌骨理解试验。使用术前和术后Lysholm和Kujala评分评估膝关节功能。
结果：该研究包括39个膝盖，由22名女性和17名男性组成，平均年龄为21.10±7.26岁。通过电话或面对面问卷对患者进行至少24个月的随访。所有患者术前均有≥2次髌骨脱位,都没有手术治疗。手术期间,所有患者均接受了孤立的MPFL重建和外侧视网膜松解术.平均Kujala和Lysholm评分分别为91.28±4.90和90.67±5.15。平均PTA和PCA分别为11.5±2.63和2.38±3.58。研究发现，复发性髌骨脱位患者恢复髌股轨道需要约27.39±5.57N（14.3-33.5N）的张力。随访期间无患者需要再次手术。总的来说,39例患者中有36例（92.31%）在最后一次随访时完成日常活动时没有疼痛。
结论：结论：在临床实践中，大约27.39±5.57N的张力水平是恢复正常的髌股关系所必需的，这表明使用2N的张力太低。在髌股韧带重建过程中使用张力计是治疗复发性髌骨脱位的更准确和可靠的手术方法。
方法：该研究纳入了39例复发性髌骨脱位患者。术前计算机断层扫描和X射线证实髌骨不稳定，髌骨倾斜角髌骨全等角及脱位史和髌骨理解试验。使用术前和术后Lysholm和Kujala评分评估膝关节功能。
结果：该研究包括39个膝盖，由22名女性和17名男性组成，平均年龄为21.10±7.26岁。通过电话或面对面问卷对患者进行至少24个月的随访。所有患者术前均有≥2次髌骨脱位,都没有手术治疗。手术期间,所有患者均接受了孤立的MPFL重建和外侧视网膜松解术.平均Kujala和Lysholm评分分别为91.28±4.90和90.67±5.15。平均PTA和PCA分别为11.5±2.63和2.38±3.58。研究发现，复发性髌骨脱位患者恢复髌股轨道需要约27.39±5.57N（14.3-33.5N）的张力。随访期间无患者需要再次手术。总的来说,39例患者中有36例（92.31%）在最后一次随访时完成日常活动时没有疼痛。
结论：结论：在临床实践中，大约27.39±5.57N的张力水平是恢复正常的髌股关系所必需的，这表明使用2N的张力太低。在髌股韧带重建过程中使用张力计是治疗复发性髌骨脱位的更准确和可靠的手术方法。
