The Relationship Between Clinical Efficary Of Which The Reconstruction Of The Medial Patellofemoral Ligament And The TT-TG

Objective:Reconstructing the MPFL under the Arthroscopy to cure the Recurrentpatellar dislocation,to discuss the relationship between clinical efficary of thereconstruction of the medial patellofemoral ligament and the TT—TG,and the importof the shift operation of the tibial tuberosity.Methods:40patients collected form the henan province people‵s hospitalorthopedics ward Ⅰfrom102011to42013, all of them wo all reconstruct the MPFLuse the Autogenous semitendinosus under the Arthroscopy to cure the recurrentpatellar dislocation,and to the patients who‵TT—TG≧15mm,wo donot do the shiftoperation.According to the TT—TG,we divide the patients two groups,A:20cases,TT—TG﹤15mm,B:20cases,TT—TG≧15mm.A:male:8.female:12.Age:16years~42years,27years average.left leg13cases,right leg7cases;B:male:6.female:14.Age:19years~45years,29years average.left leg9cases,right leg11cases.To the two groups,we all follow—up6weeks,4months,6months,12months after surgery.we all collect the data of Patellarstability(Extrapolation patella test、 Extrapolation patella fear test、 J—sign test、Dislocation times)，Lysholm score，HSS score.we comparative analysis the databetween A and B before and after surgery.we also comparative analysis the data Agroup within and B group within before and after surgery.Results:The40patients who selected by us have been followed up for6weeks to12months.when the end, compared with that of before surgery,all the symptom of thepatients that of preoperative and positive signs are all pass off basically,and we getgood Patellar stability.Joint function and stability are back to normal.Group A:at theend of the follow-up.Lysholm scale from37.80±5.10points rise to94.10±2.33points,HSS scale from36.70±4.82points rise to94.45±1.09points (P<0.05),The Difference was Statistical significance.Group B:at the end of the follow-up Lysholm scale from37.10±4.97points rise to93.15±3.11points, HSS scale from36.20±5.07points rise to93.65±1.18points (P<0.05),The Difference was Statistical significance. the twogroups both were compared with each other in6weeks,4months,6months and12months postoperatively:Lysholm scale(62.80±5.92、62.00±5.78)，(78.65±3.88、77.45±3.61)，（87.45±2.87、86.90±3.46)，（94.10±2.33、93.15±3.11); HSS scale（61.50±4.51、60.75±4.68），（84.90±2.69、84.30±2.69），（90.85±1.98、90.45±1.93），（94.45±1.09、93.65±1.18).Between A and B two groups werecompared in the same period of time follow-up after the surgery, the differencesbetween of Lysholm scaled and HSS scale have no statistical significance(P﹥0.05).Conclusions:MPFL reconstruction under arthroscopy treatment can obviouslyimprove the Patellar stability,the efficacy is very good.To the patientswho‵TT—TG≧15mm,we just do the MPFL reconstruction,we also reach thepurpose of Stabilize the patella,avoid dislocation.Thus proving the patientswho‵TT—TG≧15mm,we can also get good Surgical results without the shiftoperation of Tibial tuberosity.Action of the shift operation of Tibial tuberosity in thepatients of Recurrent dislocation of the patella remain futher researth.