Good outcomes seen at midterm follow-up after isolated MPFL reconstruction
Overall, good outcomes were seen after isolated medial patellofemoral ligament reconstruction at midterm follow-up, according to recently published results. However, patients with a high preoperative patellar tilt, small correction in tilt and those who had femoral tunnel malpositioning saw less improvement in clinical outcomes.
Researchers identified 107 patients who underwent isolated medial patellofemoral ligament reconstruction. The mean follow-up was 59 months. Preoperatively and every 12 months, the functional IKDC and Kujala scores were assessed. Preoperatively and at 6 months, radiological assessment of patellar height and tilt was performed, as well as CT scan measurement of patellar tilt and tibial tubercle-trochlear groove distance. Investigators used Schöttle’s criteria to assess femoral tunnel position. A 3-D CT scan was used at 6 months to measure the amount of femoral tunnel widening. Univariate and multivariate regression analyses were used to determine clinical and radiological predictors preoperatively and postoperatively.
Results showed a significant improvement in IKDC and Kujala functional scores from preoperative to postoperative measures. Functional scores were not affected by demographics, dislocation characteristics, clinical data and complications. Small correction of the patellar tilt reported on the CT scan measurement, malpositioning of the femoral tunnel and widening of the tunnel near the medial cortex were among predictors of a lower improvement in functional scores. There was a correlation between tunnel widening, patients with anterior and proximal malpositioning who had stiffness in flexion and malpositioning of the femoral tunnel. – by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.