Patellofemoral Update

Patellofemoral Update

Perspective from Shital N. Parikh, MD
Disclosures: The authors report no relevant financial disclosures.
December 09, 2021
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MPFL reconstruction yields ‘excellent midterm results’ in skeletally immature patients

Perspective from Shital N. Parikh, MD
Disclosures: The authors report no relevant financial disclosures.
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Regardless of patellar height and trochlear dysplasia, isolated medial patellofemoral ligament reconstruction yielded “excellent” midterm outcomes with low redislocation rates in skeletally immature patients, according to published results.

To determine whether bony abnormalities, such as patellar height and trochlear dysplasia, should be considered in skeletally immature patients undergoing isolated medial patellofemoral ligament (MPFL) reconstruction, Michael Schlumberger, MD, and colleagues analyzed outcomes of 45 MPFL reconstructions with gracilis tendon in 41 patients (mean age of 13.8 years). Outcome measures included the Tegner Activity Scale, IKDC subjective knee form, Lysholm scores, Kujala scores, as well as reoperations and redislocations, according to the study.

Among all procedures, 19 cases (42.2%) involved type A and B trochlear dysplasia, six cases (13.3%) involved type C trochlear dysplasia and one case (2.2%) involved type D trochlear dysplasia.

After a mean follow-up of 4.3 years, Schlumberger and colleagues determined patellar height and trochlear dysplasia had no influence on redislocation or clinical scores. Patellar redislocation occurred in three patients (6.7%). At final follow-up, mean Tegner score was 6.3; subjective IKDC score was 93.6; Lysholm score was 95.9 and Kujala score was 97.9.

“Isolated MPFL reconstruction as first-line surgical treatment in skeletally immature patients yields excellent midterm results, irrespective of patellar height and trochlear dysplasia,” the researchers concluded. “Redislocation still occurs in a certain number of patients, and a higher degree of retropatellar chondral lesion is a predictor for a worse clinical outcome,” they added.