PDF(Pubmed)
Abstract：
BACKGROUND: Patellar dislocation is common in young people. Although isolated anatomic double-bundle reconstruction of the MPFL is a common and effective surgical treatment for patellofemoral instability, concerns about the risk of injury to the epiphysis remain.
METHODS: A total of 21 children and adolescents (9 males, 12 females; mean age: 10.7 years; range: 8 to 13 years) with recurrent patella dislocation or symptomatic instability following a primary dislocation were enrolled in the study. In all patients, double-bundle medial patellofemoral ligament (MPFL) reconstruction and femoral sling procedure were performed under arthroscopy, using an anterior half peroneus longus tendon (AHPLT) autograft. Functional outcomes were evaluated preoperatively and during follow-ups based on Kujala and Lysholm scores. Radiological examinations including radiographs, 3D-CT, and MRI were performed pre- and post-operatively.
RESULTS: Among two-year postoperative follow-up (range: 24-42 months) showed significant improvement in functional scores (p < 0.01). The Lysholm score increased from 68 (44.5) to 100 (0) and the Kujala score increased from 26 (34.5) to 100 (2) The patellar tilt angel improved significantly (p < 0.01) from 24.3° ± 10.4 preoperatively to 11.9° ± 7.0 postoperatively. MRIs performed 6- and 12-months post operation did not show any signs of dysfunction of the reconstructed MPFL or cartilage degeneration.
METHODS: Case Series; Level of evidence, 4.
CONCLUSIONS: Arthroscopic reconstruction of the MPFL using the modified sling procedure is an effective procedure for the treatment of patellar instability in skeletally immature patients.
METHODS: A total of 21 children and adolescents (9 males, 12 females; mean age: 10.7 years; range: 8 to 13 years) with recurrent patella dislocation or symptomatic instability following a primary dislocation were enrolled in the study. In all patients, double-bundle medial patellofemoral ligament (MPFL) reconstruction and femoral sling procedure were performed under arthroscopy, using an anterior half peroneus longus tendon (AHPLT) autograft. Functional outcomes were evaluated preoperatively and during follow-ups based on Kujala and Lysholm scores. Radiological examinations including radiographs, 3D-CT, and MRI were performed pre- and post-operatively.
RESULTS: Among two-year postoperative follow-up (range: 24-42 months) showed significant improvement in functional scores (p < 0.01). The Lysholm score increased from 68 (44.5) to 100 (0) and the Kujala score increased from 26 (34.5) to 100 (2) The patellar tilt angel improved significantly (p < 0.01) from 24.3° ± 10.4 preoperatively to 11.9° ± 7.0 postoperatively. MRIs performed 6- and 12-months post operation did not show any signs of dysfunction of the reconstructed MPFL or cartilage degeneration.
METHODS: Case Series; Level of evidence, 4.
CONCLUSIONS: Arthroscopic reconstruction of the MPFL using the modified sling procedure is an effective procedure for the treatment of patellar instability in skeletally immature patients.
摘要：
背景：髌骨脱位在年轻人中很常见。尽管孤立的解剖双束重建MPFL是髌股不稳定的常见和有效的手术治疗方法，骨phy损伤的风险仍然存在。
方法：共有21名儿童和青少年（9名男性，12名女性；平均年龄：10.7岁；范围：8至13岁），原发性脱位后复发性髌骨脱位或症状不稳定被纳入研究。在所有患者中，在关节镜下进行双束内侧髌股韧带（MPFL）重建和股骨悬吊术，使用腓骨前半长肌腱（AHPLT）自体移植。根据Kujala和Lysholm评分评估术前和随访期间的功能结果。放射学检查，包括射线照片，3D-CT,术前和术后进行MRI检查。
结果：在术后2年随访（范围：24-42个月）中，功能评分显着改善（p<0.01）。Lysholm评分从68(44.5)提高到100(0),Kujala评分从26(34.5)提高到100(2)髌骨倾斜角度从术前24.3°±10.4显著改善(p<0.01),术后11.9°±7.0。术后6个月和12个月进行的MRI未显示任何重建的MPFL功能障碍或软骨退变的迹象。
方法：案例系列；证据级别，4.
结论：关节镜下使用改良的悬吊术重建MPFL是治疗骨骼未成熟患者髌骨不稳定的有效方法。
方法：共有21名儿童和青少年（9名男性，12名女性；平均年龄：10.7岁；范围：8至13岁），原发性脱位后复发性髌骨脱位或症状不稳定被纳入研究。在所有患者中，在关节镜下进行双束内侧髌股韧带（MPFL）重建和股骨悬吊术，使用腓骨前半长肌腱（AHPLT）自体移植。根据Kujala和Lysholm评分评估术前和随访期间的功能结果。放射学检查，包括射线照片，3D-CT,术前和术后进行MRI检查。
结果：在术后2年随访（范围：24-42个月）中，功能评分显着改善（p<0.01）。Lysholm评分从68(44.5)提高到100(0),Kujala评分从26(34.5)提高到100(2)髌骨倾斜角度从术前24.3°±10.4显著改善(p<0.01),术后11.9°±7.0。术后6个月和12个月进行的MRI未显示任何重建的MPFL功能障碍或软骨退变的迹象。
方法：案例系列；证据级别，4.
结论：关节镜下使用改良的悬吊术重建MPFL是治疗骨骼未成熟患者髌骨不稳定的有效方法。
