Clinical Research Of Lateral Patellar Retinaculum Releasing And Medial Patellar Retnaculum Reefing And With Tibial Tubercle Anteromedial Transfer For The Treatment Of Patellar Istability

Objective: To investigate the Clinical reseach of lateral Patellar retinaculum releasing andmedial Patellar retinaculum reefing and with tibial tubercle anteromedial transfer for thetreatment of patellar instability .Providing us an effective way to the surgery treatment of patellarinstability.Methods:From Mar 2004 to Dec 2010,32patients(36 knees) in orthopedics department of thesecond hospital attached to Shanxi medical university who were diagnosed of patellar instabilityby symptom,routine physical inspects, medical examination and radio-graphic methods,treatedwith lateral Patellar retinaculum releasing and medial Patellar retinaculum reefing and with tibialtubercle anteromedial transfer,with an average age of 19.7(10-48)years.30 patients(34 knees)including Male 9(10 knees) and Female 21(24 knees) got an investgation post-operation,the ratioof follow-up evaluated is 93.7%,and the average period was 45.6(5-80)months.The patients wereassessed in pre-operation and post-operation with the Fukerson patellofemal score measure andkujala patellofemal score measure,comparing the therapy outcome with this operationway.Besides,takeing the axial X-ray with the knee in 30°flexion(Ficat ways), measured andcompared the indexs which describe the apposition of patellofemoral joint in 20 patients(22knees),including:LPA,CA,PFI,FTA,LS.Results: In 30 patients(34 knees),the Fukerson patellofemoral score was average 58.60士8.90points(range,45 to 70points) pre-operation and 86.25士5.36 points(range,80 to 93 points)post-operation;While the kujala patellofemoral score was average 55.16士11.80 points(range,42 to 68 points)pre-operation and 85.15士7.12 points(range,78 to 95 points)post-operation. There were obvious statistical differences(P<0.01)between pre-operation andpost-operation.The function of the patellarmoral joint has changed significantly. Make acomparison of the indexs including LPA,CA,PFI,LS,which were gotten from axial X-ray withthe knee in 30°flexion,they were all changed significantly(P＜0.01).Conclusion: The lateral Patellar retinaculum releasing and medial Patellar retinaculum reefingand with tibial tubercle anteromedial transfer is an effective way to treat the patellarinstability,which could rectify the abnormal involution of patellofemoral joint, improve thefunction of patellofemoral joint greatly.