Philip P Roessler1, Matthias D Wimmer2, Cornelius Jacobs2, Rahel Bornemann2, Thomas Stein3, Matthias Lahner4. 1. Department of Orthopaedics and Traumatology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. philip.roessler@ukbonn.de. 2. Department of Orthopaedics and Traumatology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. 3. Department of Sporttraumatology, Knee and Shoulder-Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany. 4. Joint Center Hilden, Ruhr-University Bochum, Bochum, Germany.
Abstract
PURPOSE: Medial patellofemoral ligament reconstruction (MPFL-R) is the gold standard in patella soft tissue surgery for patellofemoral instability. Although claimed, recent reports indicate that MPFL-R may fail to distalize the patella in mild cases of patella alta. The present study is a retrospective case-control study to compare radiographic patella height between MPFL-R and historical Insall's proximal realignment (IPR) pre- and post-operatively with respect to distalization and assess redislocation rates at a mid-term follow-up. METHODS: Sixty-four patients were age/sex matched (1:1), yielding 32 patients for group 1 MPFL-R (cases) and 32 patients for group 2 IPR (controls). Insall-Salvati, Blackburne-Peel and Caton-Deschamps indices were analyzed for differences pre- and post-operatively. An additional inter-rater reliability analysis was performed by means of intra-class correlation (ICC). Redislocation rates were considered as treatment failures in this study. RESULTS: ICC was excellent for all three patella indices. MPFL-R failed to show significant differences if compared to IPR with respect to distalization in mild stages of patella alta. Moreover, redislocation rates significantly favored MPFL-R (3.1%) over IPR (12.5%; p < 0.0001). CONCLUSIONS: MPFL-R has become a popular option to restore native patellofemoral biomechanics after ligament rupture. However, the procedure's potential to correct concomitant patella alta should not be overestimated and indications considered carefully.
PURPOSE: Medial patellofemoral ligament reconstruction (MPFL-R) is the gold standard in patella soft tissue surgery for patellofemoral instability. Although claimed, recent reports indicate that MPFL-R may fail to distalize the patella in mild cases of patella alta. The present study is a retrospective case-control study to compare radiographic patella height between MPFL-R and historical Insall's proximal realignment (IPR) pre- and post-operatively with respect to distalization and assess redislocation rates at a mid-term follow-up. METHODS: Sixty-four patients were age/sex matched (1:1), yielding 32 patients for group 1 MPFL-R (cases) and 32 patients for group 2 IPR (controls). Insall-Salvati, Blackburne-Peel and Caton-Deschamps indices were analyzed for differences pre- and post-operatively. An additional inter-rater reliability analysis was performed by means of intra-class correlation (ICC). Redislocation rates were considered as treatment failures in this study. RESULTS: ICC was excellent for all three patella indices. MPFL-R failed to show significant differences if compared to IPR with respect to distalization in mild stages of patella alta. Moreover, redislocation rates significantly favored MPFL-R (3.1%) over IPR (12.5%; p < 0.0001). CONCLUSIONS: MPFL-R has become a popular option to restore native patellofemoral biomechanics after ligament rupture. However, the procedure's potential to correct concomitant patella alta should not be overestimated and indications considered carefully.
Authors: Dennis van Duijvenbode; Michel Stavenuiter; Bart Burger; Cees van Dijke; Jacco Spermon; Marco Hoozemans Journal: Int Orthop Date: 2015-07-16 Impact factor: 3.075
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Authors: Alex E White; Peters T Otlans; Dylan P Horan; Daniel B Calem; William D Emper; Kevin B Freedman; Fotios P Tjoumakaris Journal: Orthop J Sports Med Date: 2021-05-20