According to recently published results, patients would unlikely benefit from isolated medial patellofemoral ligament reconstruction if their patella remained dislocated past 30° of flexion. However, examination under anesthesia may offer information that could help surgeons decide on the appropriate surgical approach.
Researchers retrospectively reviewed information about examination under anesthesia for 23 patients who underwent isolated medial patellofemoral ligament (MPFL) reconstruction for recurrent patella dislocation. The mean patient age was 17.4 years. The need for revision surgery due to recurrent instability was the primary outcome of the study. The median trochlea tuberosity-trochlear groove was 15 mm. The median Caton-Deschamps ratio was 1.3.
MPFL reconstruction failed in nine patients. Investigators noted the median time to failure was 10.5 months. Patients who failed MPFL reconstruction had a dislocating patella on examination under anesthesia of more than 30° of flexion.
“Radiological assessment of the knee to assess its morphology is essential for preoperative surgical planning for patients with recurrent patellar instability,” the authors wrote. “Cutoff values to determine the need for surgical procedures require a consistent method of imaging and are prone to flaws in measurement.” – by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.