[Treatment of habitual dislocation of patella with reconstruction of medial patellofemoral ligament combined with release of lateral retinaculum and medial transfer and advancement of tibial tuberosity under arthroscopy].

OBJECTIVE

To study clinical effects of triad operation including reconstruction of medial patellofemoral ligament, release of lateral retinaculum, Fulkerson tibial tubercle osteotomy, medial transfer and advancement under arthroscopy for the treatment of habitual dislocation of patella.

METHODS

From March 2010 to May 2016, 35 patients with habitual patellar dislocation were treated with the triad operation, including 14 males, 21 females, ranging in age from 18 to 38 years old, with an average of 25.8 years old. Twelve patients had dislocations on the left knee, and 23 patients had dislocations on the right knee. The changes of Q angle, TT-TG value and Kujala score were compared before and after operation.

RESULTS

All the patients were followed up, and the duration ranged from 9 to 35 months (mean, 23 months). The Q angle of male group was improved from preoperative (29.2±2.0)° to postoperative (14.8±1.2)°(P<0.05), and the Q angle of female group was improved from preoperative(30.6±2.3)° to postoperative (16.7±1.5)° (P<0.05). CT showed that the TT-TG value was improved from preoperative (20.3±2.2) mm to postoperative (10.3±1.2) mm (P<0.05). The Kujala score was improved from preoperative 47.8±7.5 to postoperative 88.4±6.2 (P<0.05).

CONCLUSIONS

The triad operation including reconstruction of medial patellofemoral ligament, release of lateral retinacular, Fulkerson tibial tubercle osteotomy, medial transfer and advancement under arthroscopy for the treatment of habitual dislocation of patella has good short-term clinical effects.