International Journal of General Medicine (Sep 2021)

Effects of Lateral Patellar Retinaculum Release for Recurrent Patella Dislocation: A Prospective Study

  • Wang XL,
  • Peng C,
  • Tu YW,
  • Liu YP,
  • Zhang W,
  • Zhang Y,
  • Hua GJ

Journal volume & issue
Vol. Volume 14
pp. 5527 – 5535

Abstract

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Xing-Liang Wang,1 Chao Peng,2 You-Wei Tu,2 Yun-Peng Liu,2 Wei Zhang,2 Yan Zhang,2 Guo-Jun Hua3 1Department of Orthopedics, Wuxi Second People’s Hospital, Wuxi, 214000, People’s Republic of China; 2Department of Orthopedic Surgery, The No.904 Hospital of People’s Liberation Army, Wuxi 214000, People’s Republic of China; 3Department of Orthopedic Surgery, Wuxi No.2 Chinese Medicine Hospital, Wuxi, 214000, People’s Republic of ChinaCorrespondence: Guo-Jun HuaDepartment of Orthopedic Surgery, Wuxi No.2 Chinese Medicine Hospital, Wuxi, 214000, People’s Republic of ChinaEmail [email protected] WangDepartment of Orthopedics, Wuxi Second People’s Hospital, Wuxi, 214000, People’s Republic of ChinaEmail [email protected]: Recurrent patellar dislocation (RPD) is the most common complication of patellar instability and the medial patellofemoral ligament (MPFL) reconstruction has become its reference treatment. Lateral patellar retinaculum (LPR) release used to be performed in association with MPFL reconstruction. The aim of this study was to investigate the added values of MPFL reconstruction plus LPR release for RPD.Methods: After Institutional Review Board approval, RPD patients from October 2014 to April 2019 were randomly assigned into two groups (isolated MPFL reconstruction [Group I] and MPFL reconstruction plus LPR release [Group II]) and prospectively assessed until 12 months after surgery. Knee joints with flexion of 20° were scanned by a 64-row CT scanner. Congruence angle (CA), patella tilt angle (PTA), lateral patellofemoral angle (LPFA), tibial tuberosity-trochlear groove distance and patellar tilt with the quadriceps relaxed and contracted were measured. Knee function was assessed by Lysholm knee score and International Knee Documentation Committee (IKDC) score. Patients were followed up for at least 12 months.Results: A total of 87 RPD patients (45 for Group I and 42 for Group II) were selected in this study. Preoperative clinical characteristics were not significantly different across groups. No serious complications were noted in either group. It was statistically insignificant between the two group patients in terms of postoperative patella associated measurements (P > 0.05 for all). The Lysholm score and IKDC score of Group I (84.5 ± 7.1 and 87.9 ± 7.2) were significantly less than that of Group II (89.7 ± 8.7 and 93.1 ± 7.7), which indicated the better knee function of Group II.Conclusion: LPR release plus MPFL reconstruction provides additional benefits compared with isolated MPFL reconstruction in knee function. A combination of surgical treatments for RPD should be recommended.Keywords: recurrent patella dislocation, medial patellofemoral ligament reconstruction, lateral patellar retinaculum release, prospective, combination treatment

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