title: A prospective randomized trial evaluating two different tensioning techniques for medial patellofemoral ligament reconstruction.
abstract: BACKGROUND
  In the literature, graft tension was mostly assessed under direct arthroscopy vision for a MPFL reconstruction. The purpose of this study was to prospectively assess the outcomes of MPFL reconstruction with graft tension of self-balance technique in comparison with arthroscopy-view technique.
  
  
  METHODS
  Sixty patients with recurrent patellar dislocation were randomly divided into two groups to undergo MPFL reconstruction with graft tension either by the self-balance technique (SB group) or the arthroscopy-view technique (AV group). At a minimum of 24months of follow up, patellar stability was evaluated with the apprehension test. Patellofemoral morphology was measured on an axial CT scan and knee function was evaluated using the Kujala and Lysholm scores.
  
  
  RESULTS
  Twenty-three patients in the SB group and 25 patients in the AV group were followed for a minimum of 24months. No recurrent dislocation or subluxation was reported. Apprehension signs remained in two patients in the SB group and in one patient in the AV group. The postoperative Kujala score for the SB group and AV group were 91.4±5.1 and 90.3±5.5, respectively, and the Lysholm score was 90.1±6.4 and 88.4±6.3, respectively, with no significant differences. On CT images, congruence angle, patellar tilt angle and lateral patellar angle were restored to the normal range.
  
  
  CONCLUSIONS
  At a minimum of 24months of follow-up, graft tensioning using the self-balance technique yielded similar patellar stability and knee function compared with the arthroscopy-view procedure in the MPFL reconstruction. The self-balance technique as a simple procedure is recommended as a good alternative method for graft tensioning in the MPFL reconstruction.
authors.affiliation: Department of Orthopaedic Surgery, Shijiazhuang No. 1 Hospital, Shijiazhuang, China.
authors.forename: Huijun
authors.initials: H
authors.lastname: Kang
authors.affiliation: Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China. Electronic address: doctorwf@yeah.net.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, Shijiazhuang No. 1 Hospital, Shijiazhuang, China.
authors.forename: Jianhui
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of Orthopaedic Surgery, Shijiazhuang No. 1 Hospital, Shijiazhuang, China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Ji
mesh_terms: D000328:Adult; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D057071:Patellofemoral Joint / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D055815:Young Adult
keywords: Anatomical reconstruction; Arthroscopy; Graft tension; Medial patellofemoral ligament; Patellar dislocation