{"title":"双束半腱肌技术与带蒂股四头肌技术治疗髌骨不稳的比较。","authors":"Tayfun Özel, Semih Yaş, Hayati Hürol Türkoğlu, Asim Ahmadov, Muhammet Baybars Ataoğlu, Ulunay Kanatlı","doi":"10.1002/ksa.12619","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare clinical and functional outcomes of medial patellofemoral ligament (MPFL) reconstruction using a minimally invasive pedicled quadriceps tendon (QT) or patella double tunnel technique with semitendinosus tendon (ST) graft in patients with recurrent patella dislocation.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 51 patients who underwent MPFL reconstruction between 2014 and 2022, with a minimum 2-year post-operative follow-up. Patients were grouped as QT (n = 24) and ST (n = 27), alongside a control group of 24 healthy individuals. Kujala, Lysholm and Visual Analogue Scale (VAS) scores were evaluated. Isokinetic tests at 60° angular velocity were performed to calculate the limb symmetry index (LSI) and hamstring/quadriceps (H/Q) ratio.</p><p><strong>Results: </strong>No significant differences were found between groups regarding age, sex, body mass index, time to surgery, or number of dislocations (n.s). Mean Kujala (QT: 89.2 ± 8.9, ST: 85.4 ± 11.4), Lysholm (QT: 90.6 ± 9.4, ST: 87.9 ± 10.7), and VAS (QT: 0.83 ± 1.3, ST: 0.9 ± 1.1) scores showed no statistically significant differences between the groups (n.s). Extension LSI was significantly higher in QT (92.2 ± 10.0%) than ST (81.4 ± 16.4%, p = 0.024), as was flexion LSI (QT: 94.2 ± 10.9%, ST: 83.3 ± 17.5%, p < 0.01). H/Q ratios showed no significant differences between operated and non-operated sides (n.s). No redislocations or patellar fractures occurred. Apprehension signs were positive in two patients (7.4%) in ST and one patient (4.1%) in QT.</p><p><strong>Conclusion: </strong>MPFL reconstruction with both ST and pedicled QT grafts yields successful results in well-selected patient groups. Unlike ST, reconstruction with QT results in extension and flexion strength in the operated extremity that is closer to the non-operated side and to the healthy control group.</p><p><strong>Level of evidence: </strong>Level III, retrospective case-control study.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of double bundle semitendinosus technique and pedicled quadriceps technique in patellar instability.\",\"authors\":\"Tayfun Özel, Semih Yaş, Hayati Hürol Türkoğlu, Asim Ahmadov, Muhammet Baybars Ataoğlu, Ulunay Kanatlı\",\"doi\":\"10.1002/ksa.12619\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To compare clinical and functional outcomes of medial patellofemoral ligament (MPFL) reconstruction using a minimally invasive pedicled quadriceps tendon (QT) or patella double tunnel technique with semitendinosus tendon (ST) graft in patients with recurrent patella dislocation.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 51 patients who underwent MPFL reconstruction between 2014 and 2022, with a minimum 2-year post-operative follow-up. Patients were grouped as QT (n = 24) and ST (n = 27), alongside a control group of 24 healthy individuals. Kujala, Lysholm and Visual Analogue Scale (VAS) scores were evaluated. Isokinetic tests at 60° angular velocity were performed to calculate the limb symmetry index (LSI) and hamstring/quadriceps (H/Q) ratio.</p><p><strong>Results: </strong>No significant differences were found between groups regarding age, sex, body mass index, time to surgery, or number of dislocations (n.s). Mean Kujala (QT: 89.2 ± 8.9, ST: 85.4 ± 11.4), Lysholm (QT: 90.6 ± 9.4, ST: 87.9 ± 10.7), and VAS (QT: 0.83 ± 1.3, ST: 0.9 ± 1.1) scores showed no statistically significant differences between the groups (n.s). Extension LSI was significantly higher in QT (92.2 ± 10.0%) than ST (81.4 ± 16.4%, p = 0.024), as was flexion LSI (QT: 94.2 ± 10.9%, ST: 83.3 ± 17.5%, p < 0.01). H/Q ratios showed no significant differences between operated and non-operated sides (n.s). No redislocations or patellar fractures occurred. Apprehension signs were positive in two patients (7.4%) in ST and one patient (4.1%) in QT.</p><p><strong>Conclusion: </strong>MPFL reconstruction with both ST and pedicled QT grafts yields successful results in well-selected patient groups. Unlike ST, reconstruction with QT results in extension and flexion strength in the operated extremity that is closer to the non-operated side and to the healthy control group.</p><p><strong>Level of evidence: </strong>Level III, retrospective case-control study.</p>\",\"PeriodicalId\":17880,\"journal\":{\"name\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-02-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.12619\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ksa.12619","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Comparison of double bundle semitendinosus technique and pedicled quadriceps technique in patellar instability.
Purpose: To compare clinical and functional outcomes of medial patellofemoral ligament (MPFL) reconstruction using a minimally invasive pedicled quadriceps tendon (QT) or patella double tunnel technique with semitendinosus tendon (ST) graft in patients with recurrent patella dislocation.
Methods: A retrospective analysis was conducted on 51 patients who underwent MPFL reconstruction between 2014 and 2022, with a minimum 2-year post-operative follow-up. Patients were grouped as QT (n = 24) and ST (n = 27), alongside a control group of 24 healthy individuals. Kujala, Lysholm and Visual Analogue Scale (VAS) scores were evaluated. Isokinetic tests at 60° angular velocity were performed to calculate the limb symmetry index (LSI) and hamstring/quadriceps (H/Q) ratio.
Results: No significant differences were found between groups regarding age, sex, body mass index, time to surgery, or number of dislocations (n.s). Mean Kujala (QT: 89.2 ± 8.9, ST: 85.4 ± 11.4), Lysholm (QT: 90.6 ± 9.4, ST: 87.9 ± 10.7), and VAS (QT: 0.83 ± 1.3, ST: 0.9 ± 1.1) scores showed no statistically significant differences between the groups (n.s). Extension LSI was significantly higher in QT (92.2 ± 10.0%) than ST (81.4 ± 16.4%, p = 0.024), as was flexion LSI (QT: 94.2 ± 10.9%, ST: 83.3 ± 17.5%, p < 0.01). H/Q ratios showed no significant differences between operated and non-operated sides (n.s). No redislocations or patellar fractures occurred. Apprehension signs were positive in two patients (7.4%) in ST and one patient (4.1%) in QT.
Conclusion: MPFL reconstruction with both ST and pedicled QT grafts yields successful results in well-selected patient groups. Unlike ST, reconstruction with QT results in extension and flexion strength in the operated extremity that is closer to the non-operated side and to the healthy control group.
Level of evidence: Level III, retrospective case-control study.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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