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- Title
Medial patellofemoral ligament reconstruction fails to correct mild patella alta in cases of patellofemoral instability-a case-control study.
- Authors
Roessler, Philip P.; Wimmer, Matthias D.; Jacobs, Cornelius; Bornemann, Rahel; Stein, Thomas; Lahner, Matthias
- Abstract
<bold>Purpose: </bold>Medial patellofemoral ligament reconstruction (MPFL-R) is the gold standard in patella soft tissue surgery for patellofemoral instability. Although claimed, recent reports indicate that MPFL-R may fail to distalize the patella in mild cases of patella alta. The present study is a retrospective case-control study to compare radiographic patella height between MPFL-R and historical Insall's proximal realignment (IPR) pre- and post-operatively with respect to distalization and assess redislocation rates at a mid-term follow-up.<bold>Methods: </bold>Sixty-four patients were age/sex matched (1:1), yielding 32 patients for group 1 MPFL-R (cases) and 32 patients for group 2 IPR (controls). Insall-Salvati, Blackburne-Peel and Caton-Deschamps indices were analyzed for differences pre- and post-operatively. An additional inter-rater reliability analysis was performed by means of intra-class correlation (ICC). Redislocation rates were considered as treatment failures in this study.<bold>Results: </bold>ICC was excellent for all three patella indices. MPFL-R failed to show significant differences if compared to IPR with respect to distalization in mild stages of patella alta. Moreover, redislocation rates significantly favored MPFL-R (3.1%) over IPR (12.5%; p < 0.0001).<bold>Conclusions: </bold>MPFL-R has become a popular option to restore native patellofemoral biomechanics after ligament rupture. However, the procedure's potential to correct concomitant patella alta should not be overestimated and indications considered carefully.
- Subjects
PATELLA dislocation; PATELLA; CASE-control method; LIGAMENTS; TENODESIS
- Publication
International Orthopaedics, 2019, Vol 43, Issue 9, p2071
- ISSN
0341-2695
- Publication type
journal article
- DOI
10.1007/s00264-018-4162-x