RÉSUMÉ
BACKGROUND:Traumatic patellar dislocation with medial patellofemoral ligament tearing at femoral attachment or body is usually performed by medial patellofemoral ligament reconstruction surgery.To promote tendon bone healing after medial patellofemoral ligament reconstruction,the researchers used a variety of biological treatment technologies including growth factors,stem cells and platelet-rich plasma. OBJECTIVE:To investigate the clinical effect of medial patellofemoral ligament reconstruction by leukocyte-and platelet-rich fibrin with autologous hamstring tendon for traumatic patellar dislocation. METHODS:Thirty-seven patients with traumatic patellar dislocation in First Hospital of Qinhuangdao from February 2019 to February 2021 were randomly divided into a trial group(n=18)and a control group(n=19).The trial group received medial patellofemoral ligament reconstruction by leukocyte-and platelet-rich fibrin with an autologous hamstring tendon.The control group received medial patellofemoral ligament reconstruction by a simple autologous hamstring tendon.Patients in the two groups were followed up for 12 months.Knee pain and functional status were evaluated by visual analog scale score,Lysholm score,Kujala patellofemoral joint score and knee range of motion.The patellar tilt angle,patellar congruence angle and patellar lateral shift rate of the patellofemoral joint were measured by MRI and CT films to evaluate the stability and improvement of the patellofemoral joint. RESULTS AND CONCLUSION:(1)The visual analog scale scores of the two groups at 6 and 12 months after operation were lower than those before operation(P<0.05).The Lysholm score and Kujala patellofemoral joint score at 6 and 12 months after operation were higher than those before operation(P<0.05).The Lysholm score and Kujala patellofemoral joint score in the trial group were higher than those in the control group 6 months after operation(P<0.05).There was no significant difference between the two groups in the visual analog scale score,Lysholm score and Kujala patellofemoral joint score 12 months after operation(P>0.05).(2)The patellar tilt angle,patellar congruence angle,patellar lateral shift rate and range of motion of the patellofemoral joint were significantly improved in both groups 12 months after operation(P<0.05).The patellar tilt angle was smaller in the trial group than that in the control group 12 months after operation(P<0.05).Patellar congruence angle,patellar lateral shift rate,range of motion and MRI score were not statistically significant between the two groups 12 months after operation(P>0.05).(3)These results confirm that medial patellofemoral ligament reconstruction by leukocyte-and platelet-rich fibrin with autologous hamstring tendon can treat traumatic dislocation effectively,improve the function of the knee joint,and restore the movement track of the patella.