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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Failures and Complications with MPFL reconstruction: Our experience in 215 patients
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Failures and Complications with MPFL reconstruction: Our experience in 215 patients

机译：MPFL重建的故障和并发症：我们在215名患者中的经验

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Introduction: Chronic lateral patellar instability is one of the commonly seen clinical conditions encountered by knee surgeons. Medial patellofemoral ligament (MPFL) reconstruction has become mainstay treatment over the last three decades. Upto 26% complication rates have been reported in literature with MPFL reconstruction. The purpose of this study is to analyse failure rates, complications of surgery for PF instability and to identify the predictive factors for failure. Methods: A retrospective analysis of prospectively collected data was performed of all 215 (234 knees) patients who had undergone MPFL reconstruction between October 2007 and August 2018. All the cases with any postoperative complications or failures were included. A failure was defined by a postoperative patellar dislocation or surgical revision for recurrent patellar instability or anterior knee pain not resolving with conservative methods. Other complications such as stiffness, infection, neurological deficit and deep vein thrombosis were also included. Lysholm, Kujala, Tegner and radiographic features, such as trochlear dysplasia according to Dejour classification, patellar height with the Caton-Deschamps index (CDI), tibial tubercle-trochlear groove distance were analysed pre and post operatively. Results: Ten patients (4.27%) had a revision of MPFL reconstruction, seven patients (3%) had removal of their metal work. Post-operative stiffness was in only three patients (1.28%) and required manipulation under anesthesia. Six patients (2.56%) had patellofemoral replacement over time while three patients had arthroscopic debridement for cartilage related pathology. There was also one case each of femoral nerve palsy(related to the nerve block), post-operative deep infection, deep vein thrombosis?. Conclusion: To our knowledge, this is the only study recording the failures and complications of MPFL reconstruction on a large patient database. Age above 30, obesity, cartilage lesions, hyperlaxity and female gender are predictors of a poor subjective outcome. Identifying the potential risk factors preoperatively can prevent future complications.
机译：简介：慢性侧髌骨不稳定性是膝关节外科医生遇到的常见临床条件之一。内侧Patellofemoral韧带（MPFL）重建已成为过去三十年的主干处理。在文献中，在MPFL重建中报告了高达26％的并发症率。本研究的目的是分析失败率，手术的并发症对于PF不稳定性，并确定失败的预测因素。方法：对预期收集的数据进行回顾性分析，对所有215（234名）患者进行了2007年10月和2018年8月的MPFL重建。所有术后并发症或失败的所有病例都包含在内。失败是由术后髌骨位错或手术修订来定义复发性髌骨不稳定性或前膝关节疼痛未与保守方法分辨。还包括其他并发症，如刚度，感染，神经缺陷和深静脉血栓形成。 Lysholm，Kujala，Tegner和射线照相特征，如Trochlear Dysplasia根据Dejour分类，髌骨高度与Caton-Deschamps指数（CDI），分析了Pre和Post操作性地分析了胫骨结节螺纹槽距离。结果：10名患者（4.27％）对MPFL重建进行了修订，7名患者（3％）拆除了金属工作。术后刚度仅为3名患者（1.28％），在麻醉下需要操纵。六名患者（2.56％）随着时间的推移，具有Patelloforal替代，而三名患者对软骨相关病理有关节性清创。还有一种股骨神经麻痹（与神经嵌段有关），术后深感染，深静脉血栓形成的血栓形成？结论：据我们所知，这是唯一一项记录MPFL重建在大型患者数据库上的失败和并发症的研究。年龄以上30，肥胖，软骨病变，高级和女性性别是一个非常糟糕的主观结果的预测因素。术前识别潜在的风险因素可以防止未来的并发症。

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