Literature DB >> 31876167

Relationship between Anatomical Risk Factors, Articular Cartilage Lesions, and Patient Outcomes Following Medial Patellofemoral Ligament Reconstruction.

Charles L Holliday1, Laurie A Hiemstra2, Sarah Kerslake2, John A Grant3.   

Abstract

OBJECTIVE: The purpose of this study was (1) to determine which risk factors for patellar instability were associated with the presence of patellofemoral cartilage lesions and (2) to determine how cartilage lesion presence, size, and grade affect postoperative disease-specific quality of life.
DESIGN: Preoperative, intraoperative, and postoperative demographic, anthropometric (body mass index, Beighton score, hip rotation), radiographic (crossover sign, trochlear bump), cartilage lesion morphology (presence, size, location, grade), and outcomes data (Banff Patella Instability Instrument 2.0 [BPII 2.0]) were prospectively collected from patients undergoing isolated medial patellofemoral ligament reconstruction. For all knees (n = 264), single and multivariable logistic regression was used to determine if any patellar instability risk factors affected the odds of having a cartilage lesion. In patients with unilateral symptoms (n = 121), single variable linear regression was used to determine if the presence, size, or ICRS (International Cartilage Regeneration & Joint Preservation Society) grade of cartilage lesions could predict the 12 or 24+ month postoperative BPII 2.0 score.
RESULTS: A total of 84.5% of knees had patellofemoral cartilage lesions (88.3% involved the distal-medial patella). Trochlear dysplasia (high grade: odds ratio = 15.7, P < 0.001; low grade: odds ratio = 2.9, P = 0.015) was associated with the presence of a cartilage lesion. The presence, size, and grade of cartilage lesions were not associated with 12 or 24+ month postoperative BPII 2.0 scores.
CONCLUSIONS: Trochlear dysplasia was a risk factor for the development of patellofemoral cartilage lesions in this patient population. Cartilage lesions most commonly involve the distal-medial patella. There was no significant relationship between patellofemoral cartilage lesion presence, size, or grade and postoperative BPII 2.0 scores in short-term follow-up.

Entities:  

Keywords:  cartilage defect; patellar instability; trochlear dysplasia

Mesh:

Year:  2019        PMID: 31876167      PMCID: PMC8808921          DOI: 10.1177/1947603519894728

Source DB:  PubMed          Journal:  Cartilage        ISSN: 1947-6035            Impact factor:   3.117


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2.  Assessment of demographic and pathoanatomic risk factors in recurrent patellofemoral instability.

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Authors:  Richard Y Hinton; Krishn M Sharma
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4.  Introduction of a classification system for patients with patellofemoral instability (WARPS and STAID).

Authors:  Laurie A Hiemstra; Sarah Kerslake; Mark Lafave; S Mark Heard; Gregory M L Buchko
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5.  Is there an association between chronicity of patellar instability and patellofemoral cartilage lesions? An arthroscopic assessment of chondral injury.

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Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2016-04-27       Impact factor: 4.342

Review 7.  Chondral and osteochondral injuries associated with acute patellar dislocation.

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8.  Adolescent knee pain and patellar dislocations are associated with patellofemoral osteoarthritis in adulthood: A case control study.

Authors:  Henry Conchie; Damian Clark; Andrew Metcalfe; Jonathan Eldridge; Michael Whitehouse
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9.  Arthroscopic findings at the time of patellar realignment surgery in adolescents.

Authors:  Scott J Luhmann; Perry L Schoenecker; Matthew B Dobbs; J Eric Gordon
Journal:  J Pediatr Orthop       Date:  2007 Jul-Aug       Impact factor: 2.324

10.  Articular hypermobility and chondral injury in patients with acute patellar dislocation.

Authors:  C L Stanitski
Journal:  Am J Sports Med       Date:  1995 Mar-Apr       Impact factor: 6.202

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Authors:  Karan Patel; Nabeel S Salka; Austin Ramme; Jaron C Scott; John A Grant
Journal:  Cartilage       Date:  2020-08-20       Impact factor: 3.117

2.  Anatomical femoral tunnel positioning in the medial patellofemoral ligament reconstruction: is the free-hand technique accurate?

Authors:  Guilherme Moreira de Abreu-E-Silva; Felipe Antônio Ruy Buarque; Thiago Scherr Dias; Pengfei Lei; Elton Luis Ribeiro Bueno; Marco Antônio Percope de Andrade
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