NDLI: Clinical outcomes and predictive factors for failure with MPFL reconstruction combined with tibial tubercle osteotomy and lateral retinacular release for recurrent patellar instability

Content Provider	Springer Nature : BioMed Central
Author	Su, Peng Liu, Xiumin Jian, Nengri Li, Jian Fu, Weili
Abstract	Background Medial patellofemoral ligament (MPFL) reconstruction combined with tibial tubercle osteotomy (TTO) and lateral retinacular release (LRR) is one of the main treatment methods for patellar instability. So far, few studies have evaluated the clinical effectiveness and assessed potential risk factors for recurrent patellar instability. Purpose To report the clinical outcomes of MPFL reconstruction combined with TTO and LRR at least three years after operation and to identify potential risk factors for recurrent patellar instability. Methods A retrospective analysis of medical records for patients treated with MPFL, TTO and LRR from 2013 to 2017 was performed. Preoperative assessment for imaging examination included trochlear dysplasia according to Dejour classification, patella alta with the Caton-Deschamps index (CDI), tibial tubercle–trochlear groove distance. Postoperative assessment for knee function included Kujala, IKDC and Tegner scores. Failure rate which was defined by a postoperative dislocation was also reported. Results A total of 108 knees in 98 patients were included in the study. The mean age at operation was 19.2 ± 6.1 years (range, 13–40 years), and the mean follow-up was 61.3 ± 15.4 months (range, 36–92 months). All patients included had trochlear dysplasia (A, 24%; B, 17%; C, 35%; D, 24%), and 67% had patellar alta. The mean postoperative scores of Tegner, Kujala and IKDC were 5.3 ± 1.3 (2–8), 90.5 ± 15.5 (24–100) and 72.7 ± 12.1 (26–86). Postoperative dislocation happened in 6 patients (5.6%). Female gender was a risk factor for lower IKDC (70.7 vs 78.1, P = 0.006), Tegner (5.1 vs 6.0, P = 0.006) and Kujala (88.2 vs 96.6, P = 0.008). Age (p = 0.011) and trochlear dysplasia (p = 0.016) were considered to be two failure factors for MPFL combined with TTO and LRR. Conclusion As a surgical method, MPFL combined with TTO and LRR would be a reliable choice with a low failure rate (5.6%). Female gender was a risk factor for worse postoperative outcomes. Preoperative failure risk factors in this study were age and trochlear dysplasia. Level of Evidence Level IV; Case series
Related Links	https://bmcmusculoskeletdisord.biomedcentral.com/counter/pdf/10.1186/s12891-021-04508-x.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14712474
DOI	10.1186/s12891-021-04508-x
Journal	BMC Musculoskeletal Disorders
Issue Number	1
Volume Number	22
Language	English
Publisher	BioMed Central
Publisher Date	2021-07-21
Access Restriction	Open
Subject Keyword	Orthopedics Rehabilitation Rheumatology Sports Medicine Internal Medicine Epidemiology Medial patellofemoral ligament reconstruction Tibial tubercle osteotomy Lateral retinacular release Patellar alta Recurrent patellar instability Caton-Deschamps index Tibial tubercle–trochlear groove distance Trochlear dysplasia
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Rheumatology
Journal Impact Factor	2.2/2023
5-Year Journal Impact Factor	2.6/2023

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