Good results seen with single-bundle transpatellar tunnel and double-anchor anatomic techniques for ligament reconstruction
Although good results were achieved by both the single-bundle transpatellar tunnel technique and the double-anchor anatomic reconstruction technique for medial patellofemoral ligament reconstruction, according to recently published results, the double-anchor anatomic technique may be more effective as it provided a more congruous patellofemoral joint and better knee function.
Researchers randomly categorized 91 patients with recurrent patellar dislocation to either receive the traditional single-bundle transpatellar tunnel technique or the double-anchor anatomic reconstruction technique. CT with congruence angle, lateral patellar angle, patellar tilt angle and lateral patellar translation were used to evaluate the patellar position and rotation preoperatively and at the follow-up. The mean follow-up was 41.1 months. Kujala, Lysholm, Tegner and the IKDC scores were used to assess subjective symptoms and functional outcomes. Investigators conducted clinical examinations and also recorded any redislocations or episodes of instability.
Results showed no recurrent patellar dislocations occurred at the final follow-up, apart from four patients with instability symptoms among patients who underwent medial patellofemoral ligament reconstruction with the single-bundle transpatellar tunnel technique. However, there was no significant difference between the two treatment groups. Investigators noted CT measurements decreased significantly to the normal range. The groups were not significantly different regarding this measure; however, a lesser patellar tilt angle was seen in patients who underwent medial patellofemoral ligament reconstruction with double-anchor anatomic reconstruction technique.
There were significant improvements seen in the clinical examinations. There were also no statistically significant differences seen between the two treatment groups with regard to the number of patients with abnormal lateral patellar translation grade and firm end point.
The outcome scores improved significantly between the groups, with no significant differences seen between the groups. However, higher Kujala and IKDC scores were seen in patients who underwent the double-anchor anatomic reconstruction technique. – by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.