title: [Reconstruction of medial patellofemoral ligament for recurrent patellar dislocation].
abstract: OBJECTIVE
  To investigate the procedure and effectiveness of medial patellofemoral ligament (MPFL) reconstruction for the treatment of recurrent patellar dislocation. METHODS; Between June 2005 and September 2007, 29 patients with recurrent patellar dislocation underwent MPFL reconstruction with allograft semitendinosus or allograft anterior tibialis tendon. There were 6 males and 23 females with an average age of 20.3 years (range, 13-45 years). The patients suffered from 2-10 times patellar dislocation preoperatively. The average time between last dislocation and surgery was 43.9 months (range, 1-144 months). CT scan was performed to measure the tibial tuberosity-trochlear groove distance (TT-TG). The femoral tunnel was made at the origin of MPFL insertion, just inferior to the medial epicondyle. The double L-shape patellar tunnels were made on the medial rim of patella with 4.5 mm in diameter. The loop side of the graft was fixed with a bioabsorbable interference screw in the femoral tunnel both ends of the graft. For the TT-TG was more than 20 mm, a modified Elmslie-Trillat osteotomy was performed to correct the distal alignment of patella. The arthroscopic examination was also performed for loose body and lateral retinacular release.
  
  
  RESULTS
  Twenty-seven patients were followed up 45.5 months on average (range, 40-67 months). No recurrent dislocation or subdislocation occurred. All the patients showed negative apprehension test at 0 degrees and 30 degrees flexions of knee. The range of motion of knee restored normal 1 year after operation. The Kujala score was improved from 72.03 +/- 17.38 preoperatively to 94.10 +/- 7.59 postoperatively, and Lysholm score was improved from 72.65 +/- 14.70 to 95.44 +/- 6.25, both showing significant differences (P < 0.05). The Tegner score was decreased from 5.25 +/- 1.83 preoperatively to 4.33 +/- 1.00 postoperatively, showing no significant difference (t = 1.302, P = 0.213). In patients whose TT-TG was more than 20 mm, TT-TG was decreased from (23.38 +/- 3.70) mm to (16.88 +/- 5.92) mm at last follow-up, showing significant difference (t = 2.822, P = 0.026).
  
  
  CONCLUSIONS
  The technique of MPFL reconstruction is an effective surgical procedure for the treatment of recurrent patellar dislocation, which can improve the patella stability and knee function.
authors.affiliation: Sports Medicine Service, Jishuitan Hospital, Beijing 100035, PR China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.forename: Lei
authors.initials: L
authors.lastname: Hong
authors.forename: Xiangsu
authors.initials: X
authors.lastname: Geng
authors.forename: Xuesong
authors.initials: X
authors.lastname: Wang
authors.forename: Hua
authors.initials: H
authors.lastname: Feng
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000601:surgery; D031222:Patellar Dislocation / Q000601:surgery*; D017847:Patellar Ligament / Q000601:surgery*; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D055815:Young Adult