Theodoros Bouras1, Edmond U2, Ashley Brown2, Peter Gallacher2, Andrew Barnett2. 1. Sports Knee Department, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, SY10 7AG, UK. theo_bouras@hotmail.com. 2. Sports Knee Department, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, SY10 7AG, UK.
Abstract
PURPOSE: The purpose of this study was to measure the improvement in quality of life (QoL) following isolated anatomical double-bundle medial patellofemoral ligament reconstruction. METHODS: This is a single-centre, prospective study of 56 consecutive patients (57 knees) who underwent isolated MPFL reconstruction between 2014 and 2017. Functional outcome and QoL were assessed with the Kujala score and the EQ-5D-3L questionnaire, respectively. Objective outcomes were obtained through clinical examination at the latest follow-up assessing redislocation rate, patella apprehension test, patellar tilt, pain and range of motion. RESULTS: The median Kujala score increased from 60 (range 31-96) to 92 (range 34-100) at latest follow-up (p < 0.001). The median EQ-5D index also increased, from 0.69 (range 0.10-1) at baseline to 1 (range 0.16-1) at latest follow-up (p < 0.001), as well as the median EQ-5D VAS from 75 (range 20-95) to 92 (range 40-100) (p < 0.001). Four dimensions of the EQ-5D were significantly improved except for the anxiety/depression scores. Female patients reported lower scores at baseline and at latest follow-up, for all three outcomes (Kujala, EQ-5D index, EQ-5D VAS), however there was no evidence that gender negatively impacted on the benefit of surgery. The re-dislocation rate was 0%. Apprehension and patellar tilt test were negative in all patients and no flexion deficit was identified at latest follow-up. Two patients had tenderness along the reconstruction requiring femoral screw removal in one of them. CONCLUSIONS: Isolated anatomical double-bundle aperture MPFL reconstruction, offered significantly improved short-term QoL along with excellent functional outcome. Female patients scored lower, but this did not affect the overall outcome. Including QoL tools in the assessment of ligament reconstruction operations, such as the MPFL, can provide more accurate understanding of the overall patient benefit. LEVEL OF EVIDENCE: II.
PURPOSE: The purpose of this study was to measure the improvement in quality of life (QoL) following isolated anatomical double-bundle medial patellofemoral ligament reconstruction. METHODS: This is a single-centre, prospective study of 56 consecutive patients (57 knees) who underwent isolated MPFL reconstruction between 2014 and 2017. Functional outcome and QoL were assessed with the Kujala score and the EQ-5D-3L questionnaire, respectively. Objective outcomes were obtained through clinical examination at the latest follow-up assessing redislocation rate, patella apprehension test, patellar tilt, pain and range of motion. RESULTS: The median Kujala score increased from 60 (range 31-96) to 92 (range 34-100) at latest follow-up (p < 0.001). The median EQ-5D index also increased, from 0.69 (range 0.10-1) at baseline to 1 (range 0.16-1) at latest follow-up (p < 0.001), as well as the median EQ-5D VAS from 75 (range 20-95) to 92 (range 40-100) (p < 0.001). Four dimensions of the EQ-5D were significantly improved except for the anxiety/depression scores. Female patients reported lower scores at baseline and at latest follow-up, for all three outcomes (Kujala, EQ-5D index, EQ-5D VAS), however there was no evidence that gender negatively impacted on the benefit of surgery. The re-dislocation rate was 0%. Apprehension and patellar tilt test were negative in all patients and no flexion deficit was identified at latest follow-up. Two patients had tenderness along the reconstruction requiring femoral screw removal in one of them. CONCLUSIONS: Isolated anatomical double-bundle aperture MPFL reconstruction, offered significantly improved short-term QoL along with excellent functional outcome. Female patients scored lower, but this did not affect the overall outcome. Including QoL tools in the assessment of ligament reconstruction operations, such as the MPFL, can provide more accurate understanding of the overall patient benefit. LEVEL OF EVIDENCE: II.
Entities:
Keywords:
Double-bundle anatomical aperture fixation; Medial patellofemoral ligament reconstruction; Quality of life
Authors: Jaydev B Mistry; Kevin F Bonner; Chukwuweike U Gwam; Melbin Thomas; Jennifer I Etcheson; Ronald E Delanois Journal: J Knee Surg Date: 2017-07-18 Impact factor: 2.757
Authors: Ryan J McNeilan; Joshua S Everhart; Patrick K Mescher; Moneer Abouljoud; Robert A Magnussen; David C Flanigan Journal: Arthroscopy Date: 2018-02-01 Impact factor: 4.772
Authors: Paul Y F Lee; David Golding; Sam Rozewicz; Amit Chandratreya Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-09-19 Impact factor: 4.342
Authors: Matthew D LaPrade; Samantha L Kallenbach; Zachary S Aman; Gilbert Moatshe; Hunter W Storaci; Travis Lee Turnbull; Elizabeth A Arendt; Jorge Chahla; Robert F LaPrade Journal: Am J Sports Med Date: 2018-03-19 Impact factor: 6.202
Authors: David Sadigursky; Matheus Simões de Melo Laranjeira; Marzo Nunes; Rogério Jamil Fernandes Caneiro; Paulo Oliveira Colavolpe Journal: Rev Bras Ortop Date: 2016-04-27
Authors: Julian Mehl; Alexander Otto; Brendan Comer; Cameron Kia; Franz Liska; Elifho Obopilwe; Knut Beitzel; Andreas B Imhoff; John P Fulkerson; Florian B Imhoff Journal: Knee Surg Sports Traumatol Arthrosc Date: 2019-08-13 Impact factor: 4.342