Journal Article10.1007/S00167-015-3654-0
Clinical outcome in MPFL reconstruction with and without tuberositas transposition.
Alexander Mulliez,Delphine Lambrecht,Dimitri Verbruggen,C. Van Der Straeten,Peter Verdonk,Jan Victor +5 more
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TL;DR: MPFL reconstruction is a viable treatment option for episodic patellar dislocation and a concomitant tuberositas transposition is useful in selected patients.
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Abstract: 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.
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. 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. MPFL reconstruction is a viable treatment option for episodic patellar dislocation. A concomitant tuberositas transposition is useful in selected patients. I.
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Citations
Outcomes After Isolated Medial Patellofemoral Ligament Reconstruction for the Treatment of Recurrent Lateral Patellar Dislocations A Systematic Review and Meta-analysis
Daniel K. Schneider,Daniel K. Schneider,Brian M. Grawe,Robert A. Magnussen,Adrick Ceasar,Shital N. Parikh,Eric J. Wall,Angelo J. Colosimo,Christopher C. Kaeding,Gregory D. Myer +9 more
TL;DR: A high percentage of young patients return to sports after isolated MPFL reconstruction for chronic patellar instability, with short-term results demonstrating a low incidence of recurrent instability, postoperative apprehension, and reoperations.
261
Derotational osteotomy at the distal femur is effective to treat patients with patellar instability
Florian B. Imhoff,Matthias Cotic,Franz Liska,Felix Dyrna,Knut Beitzel,Andreas B. Imhoff,Elmar Herbst +6 more
TL;DR: Combined derotational osteotomy is a suitable treatment for patellar instability due to torsional malformity, as it leads to a significant reduction of pain, and a significant increase of knee function with good-to- excellent results in the short-term follow-up.
109
Clinical Outcomes After Isolated Medial Patellofemoral Ligament Reconstruction for Patellar Instability Among Patients With Trochlear Dysplasia.
Joseph N. Liu,Jacqueline M. Brady,Irene L. Kalbian,Sabrina M. Strickland,Claire Ryan,Joseph T. Nguyen,Beth E. Shubin Stein +6 more
TL;DR: For patients without significantly elevated TT-TG distances or significant patella alta, isolated MPFL reconstruction provides a safe and effective treatment for patellofemoral instability, despite the presence of trochlear dysplasia.
106
A new classification system of patellar instability and patellar maltracking
Karl-Heinz Frosch,A. Schmeling +1 more
TL;DR: A patellar dislocation classification based on the current literature is introduced to allow for the application of a structured diagnosis and treatment algorithm based on instability criteria as well as on clinical and radiological analyses of maltracking.
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Results of medial patellofemoral ligament reconstruction compared with trochleoplasty plus individual extensor apparatus balancing in patellar instability caused by severe trochlear dysplasia: a systematic review and meta-analysis
Peter Balcarek,Stephan Rehn,N. R. Howells,Jonathan Eldridge,Keisuke Kita,David Dejour,Manfred Nelitz,Ingo J. Banke,Delphine Lambrecht,Markus Harden,Tim Friede +10 more
TL;DR: This analysis found significant post-operative improvements in patient-reported outcomes for patients undergoing both an MPFL reconstruction and in those undergoing a trochleoplasty plus an individual extensor apparatus balancing procedure when assessed using the Kujala score.
101
References
Anteromedial tibial tubercle transfer in patients with chronic anterior knee pain and a subluxation-type patellar malalignment
TL;DR: It is concluded that an isolated anteromedial tibial tubercle transfer can consistently improve patellar subluxation and tilt and, when combined with a lateral release, can improve p knee pain, resulting in improved functional scores for patients with chronic anterior knee pain.
Reconstruction of the Medial Patellofemoral Ligament for Treatment of Patellofemoral Instability A Systematic Review
TL;DR: There is limited but growing evidence that a medial patellofemoral ligament—based surgical approach to patell ofemoral instability leads to excellent functional outcomes.
Medial Patellofemoral Ligament Reconstruction With a Divergent Patellar Transverse 2-Tunnel Technique
Alfredo Schiavone Panni,Mahbub Alam,Mahbub Alam,Simone Cerciello,Michele Vasso,Nicola Maffulli +5 more
TL;DR: The results of modified MPFL reconstructions are encouraging, with minimal risks of redislocation and an overall patient satisfaction rate of over 80%.
Medial patellofemoral ligament restraint in lateral patellar translation and reconstruction.
E. Nomura,Y. Horiuchi,M. Kihara +2 more
TL;DR: The isolated sectioning of the MPFL greatly increased lateral displacement during 20-90 degrees, and the isolated MPFL reconstruction prevented patellar displacement within the normal range within 20-120 degrees.