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- Title
Surgical treatment of patellar instability: clinical and radiological outcome after medial patellofemoral ligament reconstruction and tibial tuberosity medialisation.
- Authors
Lobner, Stefan; Krauss, Christine; Reichwein, Frank; Patzer, Thilo; Nebelung, Wolfgang; Venjakob, Arne; Venjakob, Arne J
- Abstract
<bold>Introduction: </bold>The aim of this retrospective study was to analyse clinical and radiological outcome after medial patellofemoral ligament reconstruction (MPFLR) and tibial tuberosity medialisation (TTM) in patients with recurrent patellar instability.<bold>Materials and Methods: </bold>Thirty-five patients were included between 2008 and 2012. According to defined criteria such as tibial tuberosity-trochlear groove (TTTG) distance, hyperpression on the lateral patella facet and lateral retropatellar cartilage damage either MPFLR (group A) or TTM (group B) was performed: 18 patients underwent TTM, the other 17 patients underwent MPFLR. At a mean of 25.4 ± 9.7 (group A) and 35.2 ± 17.6 months (group B) patients were clinically and radiologically reviewed. Validated knee scores such as Kujala, Lysholm and Tegner score were evaluated.<bold>Results: </bold>In both groups one patient reported of a non-traumatic patellar redislocation. Patients who underwent MPFLR (group A) had less pain postoperatively during activity according to the Visual Analogue Scale (group A: 2.0 ± 2.1 points, group B: 3.9 ± 2.3 points). Retropatellar cartilage damage increased in group B from grade 1 (range: 1-3) preoperatively to grade 2 (range 1-3) postoperatively (p > 0.05). All other clinically evaluated items, as well as the applied knee scoring systems, indicated no significant difference (p > 0.05) and displayed good to excellent results.<bold>Conclusions: </bold>MPFLR and TTM leed to good clinical results despite its own indications. For this reason-in selected cases-TTM may still be a suitable procedure for surgical treatment of patellar instability. However, patients treated by TTM (group B) revealed an increased retropatellar cartilage damage as well as significantly more pain during activity.
- Subjects
PATELLOFEMORAL joint diseases; PATELLOFEMORAL joint physiology; PATIENT acceptance of health care; PATIENT selection; KNEE injuries; KNEE injury treatment; PROGNOSIS; THERAPEUTICS; TIBIA surgery; ARTICULAR ligament surgery; JOINT hypermobility; PATELLA; PLASTIC surgery; TIBIA; ARTICULAR ligaments; RETROSPECTIVE studies; SURGERY
- Publication
Archives of Orthopaedic & Trauma Surgery, 2017, Vol 137, Issue 8, p1087
- ISSN
0936-8051
- Publication type
journal article
- DOI
10.1007/s00402-017-2705-z