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International Orthopaedics

Erschienen in:

01.04.2013 | Original Paper

Double-bundle anatomical versus single-bundle isometric medial patellofemoral ligament reconstruction for patellar dislocation

verfasst von: Cheng-hai Wang, Long-fei Ma, Jian-wei Zhou, Gang Ji, Hao-yu Wang, Fei Wang, Juan Wang

Erschienen in: International Orthopaedics | Ausgabe 4/2013

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Abstract

Purpose

The purpose of this study was to evaluate reconstruction of the medial patellofemoral ligament (MPFL) using the double-bundle anatomical or single-bundle isometric procedure with respect to the patients’ clinical outcomes.

Methods

In this retrospective study, we evaluated the clinical outcome of double-bundle anatomical versus single-bundle isometric reconstruction of the MPFL for patellar dislocation patients. Sixty-three patients were included in this study from August 2004 to January 2008. From August 2004 to September 2006, MPFL reconstruction using a single-bundle isometric technique was performed in 21 patients (26 knees). Since October 2006, the double-bundle anatomical reconstruction of the MPFL has been used as the routine surgical procedure. It was performed in 37 patients (44 knees). Fifty-eight patients (70 knees) could be followed up. According to the different techniques, we divided the patients into two groups: group D with double-bundle anatomical reconstruction (37 patients) and group S with single-bundle isometric reconstruction (21 patients). Clinical evaluation consisted of the number with a patellar re-dislocation, patellar apprehension sign, Kujala score, subjective questionnaire score, the patella lateral shift rate and patellar tilt angle measured by cross-sectional CT scan.

Results

According to the Kujala score and the subjective questionnaire score, the outcome of the double-bundle group was better than the outcome of the single-bundle group especially in the long-term. Patellar re-dislocation occurred in three patients in the group S, while no re-dislocation occurred in the group D. In total, 26.9 % of group S was considered to have patellar instability, compared to 4.54 % of the group D. After operation, the patellar tilt angle (PTA) and the patella lateral shift rate (PLSR) were restored to the normal range, with statistical significance (P < 0.05) compared to the preoperative state.

Conclusion

Single- and double-bundle reconstruction of the MPFL can both effectively restore patella stability and improve knee function. However, outcomes in the follow-up period showed that the double-bundle surgery procedure was much better than in single-bundle surgery.

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Titel: Double-bundle anatomical versus single-bundle isometric medial patellofemoral ligament reconstruction for patellar dislocation
verfasst von: Cheng-hai Wang
Long-fei Ma
Jian-wei Zhou
Gang Ji
Hao-yu Wang
Fei Wang
Juan Wang
Publikationsdatum: 01.04.2013
Verlag: Springer-Verlag
Erschienen in: International Orthopaedics / Ausgabe 4/2013
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-013-1788-6

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