A Mulliez1, D Lambrecht2, D Verbruggen1, C Van Der Straeten1, P Verdonk3,4, J Victor1. 1. Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. 2. Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. delphine.lambrecht@ugent.be. 3. Department of Physiotherapy and Orthopaedic Surgery, Faculty of Medicine, Ghent University, Ghent, Belgium. 4. Department of Orthopaedic Surgery, Monica Hospitals, Antwerp, Belgium.
Abstract
PURPOSE: There are several surgical options for recurrent patella dislocations. As the reconstruction of the medial patellofemoral ligament (MPFL) has been proven to restore stability, it has become more accepted. Aim of this study was to investigate the clinical outcome after MPFL reconstruction as an isolated procedure or in association with a transposition of the tibial tubercle (in case of patella alta or an excessive TT-TG) in a large prospective cohort study. Additionally, the effect on patellar height was analysed radiographically using the Caton-Deschamps index. METHODS: In a large prospective cohort study of 129 knees in 124 patients (81 females, 48 males, mean age 22.8 ± 7.7 years), 91 knees received primary MPFL reconstruction (group 1) and 38 were a combination with a transposition of the tibial tubercle (group 2). The clinical follow-up was evaluated using KOOS and Kujala scores preoperatively and 1 year postoperatively. Patient satisfaction, complications and revision surgery were recorded. RESULTS: Overall, Kujala improved significantly from 53.5 (SD 22.7) preoperatively to 74.7 (SD 20.5) postoperatively (p < 0.01). All KOOS subdomains improved significantly (p < 0.01). No significant difference for Kujala score between groups was noticed. Revision rate was (5/129) 3.9 %. Reconstruction was supplemented with a transfer of the tibial tuberosity in (38/129) 29.4 % of the cases and shows a comparable outcome. CONCLUSION: MPFL reconstruction is a viable treatment option for episodic patellar dislocation. A concomitant tuberositas transposition is useful in selected patients. LEVEL OF EVIDENCE: I.
PURPOSE: There are several surgical options for recurrent patella dislocations. As the reconstruction of the medial patellofemoral ligament (MPFL) has been proven to restore stability, it has become more accepted. Aim of this study was to investigate the clinical outcome after MPFL reconstruction as an isolated procedure or in association with a transposition of the tibial tubercle (in case of patella alta or an excessive TT-TG) in a large prospective cohort study. Additionally, the effect on patellar height was analysed radiographically using the Caton-Deschamps index. METHODS: In a large prospective cohort study of 129 knees in 124 patients (81 females, 48 males, mean age 22.8 ± 7.7 years), 91 knees received primary MPFL reconstruction (group 1) and 38 were a combination with a transposition of the tibial tubercle (group 2). The clinical follow-up was evaluated using KOOS and Kujala scores preoperatively and 1 year postoperatively. Patient satisfaction, complications and revision surgery were recorded. RESULTS: Overall, Kujala improved significantly from 53.5 (SD 22.7) preoperatively to 74.7 (SD 20.5) postoperatively (p < 0.01). All KOOS subdomains improved significantly (p < 0.01). No significant difference for Kujala score between groups was noticed. Revision rate was (5/129) 3.9 %. Reconstruction was supplemented with a transfer of the tibial tuberosity in (38/129) 29.4 % of the cases and shows a comparable outcome. CONCLUSION: MPFL reconstruction is a viable treatment option for episodic patellar dislocation. A concomitant tuberositas transposition is useful in selected patients. LEVEL OF EVIDENCE: I.
Entities:
Keywords:
MPFL; Medial patellofemoral ligament; Patellar instability; Tibial tuberosity transfer
Authors: Sabine Lippacher; Jens Dreyhaupt; Sean R M Williams; Heiko Reichel; Manfred Nelitz Journal: Am J Sports Med Date: 2014-04-23 Impact factor: 6.202
Authors: Petri Sillanpää; Ville M Mattila; Tuomo Visuri; Heikki Mäenpää; Harri Pihlajamäki Journal: Clin Orthop Relat Res Date: 2008-03-18 Impact factor: 4.176
Authors: Manfred Nelitz; Robert Sean Williams; Sabine Lippacher; Heiko Reichel; Daniel Dornacher Journal: Int Orthop Date: 2014-07-20 Impact factor: 3.075
Authors: Peter Balcarek; Stephan Rehn; Nick R Howells; Jonathan D Eldridge; Keisuke Kita; David Dejour; Manfred Nelitz; Ingo J Banke; Delphine Lambrecht; Markus Harden; Tim Friede Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-10-27 Impact factor: 4.342
Authors: Florian B Imhoff; Matthias Cotic; Franz Liska; Felix G E Dyrna; Knut Beitzel; Andreas B Imhoff; Elmar Herbst Journal: Knee Surg Sports Traumatol Arthrosc Date: 2018-10-13 Impact factor: 4.342
Authors: Daniel K Schneider; Brian Grawe; Robert A Magnussen; Adrick Ceasar; Shital N Parikh; Eric J Wall; Angelo J Colosimo; Christopher C Kaeding; Gregory D Myer Journal: Am J Sports Med Date: 2016-02-12 Impact factor: 6.202