PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction is performed to treat recurrent patellar dislocation (RPD). However, the effectiveness of MPFL reconstruction in patients with a severely lateralised tibial tuberosity remains unknown. In this study, the clinical outcomes of MPFL reconstruction in patients with an increased tibial tuberosity-trochlear groove (TT-TG) distance were examined. METHODS: A total of thirty-four patients who underwent MPFL reconstruction for RPD were retrospectively examined. Nineteen patients with a TT-TG distance of >20 mm (increased TT-TG distance group) were compared with 15 patients with a TT-TG distance of <20 mm (control group). Clinical outcomes of MPFL reconstruction were evaluated by occurrence of re-dislocation, Crosby and Insall grading system, apprehension sign, and Kujala and Lysholm scores. RESULTS: None of the patients reported re-dislocation. Apprehension sign remained in three patients in the increased TT-TG distance group and in one patient in the control group. According to the Crosby and Insall grading system, 9 patients (47%) were excellent, 9 (47%) were good, and 1 (5%) was fair to poor in the increased TT-TG distance group, while 6 (40%) were excellent and 9 (60%) were good in the control group. Kujala and Lysholm scores were significantly improved post-operatively in both groups. No significant correlations were observed between TT-TG distance and post-operative Kujala or Lysholm score. CONCLUSION: Overall clinical outcomes of MPFL reconstruction were favourable even in patients with an increased TT-TG distance. TT-TG distance of >20 mm may not be an absolute indication for medialisation of the tibial tuberosity when performing MPFL reconstruction. LEVEL OF EVIDENCE: Case-control study, Level III.
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction is performed to treat recurrent patellar dislocation (RPD). However, the effectiveness of MPFL reconstruction in patients with a severely lateralised tibial tuberosity remains unknown. In this study, the clinical outcomes of MPFL reconstruction in patients with an increased tibial tuberosity-trochlear groove (TT-TG) distance were examined. METHODS: A total of thirty-four patients who underwent MPFL reconstruction for RPD were retrospectively examined. Nineteen patients with a TT-TG distance of >20 mm (increased TT-TG distance group) were compared with 15 patients with a TT-TG distance of <20 mm (control group). Clinical outcomes of MPFL reconstruction were evaluated by occurrence of re-dislocation, Crosby and Insall grading system, apprehension sign, and Kujala and Lysholm scores. RESULTS: None of the patients reported re-dislocation. Apprehension sign remained in three patients in the increased TT-TG distance group and in one patient in the control group. According to the Crosby and Insall grading system, 9 patients (47%) were excellent, 9 (47%) were good, and 1 (5%) was fair to poor in the increased TT-TG distance group, while 6 (40%) were excellent and 9 (60%) were good in the control group. Kujala and Lysholm scores were significantly improved post-operatively in both groups. No significant correlations were observed between TT-TG distance and post-operative Kujala or Lysholm score. CONCLUSION: Overall clinical outcomes of MPFL reconstruction were favourable even in patients with an increased TT-TG distance. TT-TG distance of >20 mm may not be an absolute indication for medialisation of the tibial tuberosity when performing MPFL reconstruction. LEVEL OF EVIDENCE: Case-control study, Level III.
Authors: Philip B Schoettle; Marco Zanetti; Burkart Seifert; Christian W A Pfirrmann; Sandro F Fucentese; Jose Romero Journal: Knee Date: 2005-07-14 Impact factor: 2.199
Authors: A Mulliez; D Lambrecht; D Verbruggen; C Van Der Straeten; P Verdonk; J Victor Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-06-02 Impact factor: 4.342
Authors: James M Weinberger; Peter D Fabricant; Samuel A Taylor; Jenny Y Mei; Kristofer J Jones Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-02-08 Impact factor: 4.342
Authors: Mark J Heidenreich; Christopher L Camp; Diane L Dahm; Michael J Stuart; Bruce A Levy; Aaron J Krych Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-07-26 Impact factor: 4.342