ObjectiveTo investigate the effectiveness of the arthroscopic lateral retinacular release combined with medial patellofemoral ligament (MPFL) reconstruction for patellar dislocation.MethodsBetween January 2016 and March 2017, 28 cases (32 knees) with patellar dislocation were treated by arthroscopic lateral retinacular release and MPFL reconstruction. There were 6 males (6 knees) and 22 females (26 knees) with an average age of 21 years (range, 17-29 years). The disease duration ranged from 2 days to 2 years (mean, 8 months). Apprehension test of all patients were positive. The preoperative Lysholm score was 68.34±12.26. Anteroposterior X-ray film showed the patellar subluxation or dislocation. The Q angle was (17.67±4.21)° and the distance of tibia tuberosity-trochlear groove was less than 20 mm. The femoral attachment of retinacular were fixed by the interference screws (16 knee) or the anchors (16 knee), respectively.ResultsAll incisions healed by first intention. All patients were followed up 6 months. The function of knee joint was significantly improved at 6 months after operation. The Lysholm score was 92.88±6.42 and the Q angle was (12.15±3.68)° at 6 months. There were significant differences in the Lysholm score and the Q angle between pre- and post-operation (t=–3.408, P=0.006; t=–2.317, P=0.004). Apprehension test of all patients were negative. No knee pain, knee weakness, and patellar dislocation occurred during follow-up. There was no significant difference in the Lysholm score and the Q Angle between the anchor group and interference screw group (t=–3.254, P=0.820; t=–3.576, P=0.940). ConclusionLateral retinacular release combined with MPFL reconstruction under arthroscopy can effectively improve the function of the knee joint for patients with Q angle less than 20° and TT-TG less than 20 mm, and the early effectiveness is good. There is no significant difference in knee function between the anchor and interference screw internal fixation.

Citation： LI Xiaojian, FU Zhanli, LÜ Changwei. Arthroscopic treatment for patellar dislocation with lateral retinacular release combined with medial patellofemoral ligament reconstruction. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(2): 169-173. doi: 10.7507/1002-1892.201711050 Copy