Osteochondral Fracture Associated With Patellar Dislocation: Surgical Treatment.

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Abstract

Conflict of interest statement: The authors declared that they have no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. 19. Acta Ortop Bras. 2022 May 23;30(3):e241172. doi: 10.1590/1413-785220223003e241172. eCollection 2022. CLINICAL RESULTS OF MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION. Gondolfo R(1), Emanuele HS(2), Guerreiro JPF(1)(2), Queiroz AO(1), Danieli MV(1)(2). Author information: (1)Uniort.e, Hospital de Ortopedia, Londrina, PR, Brazil. (2)Hospital Evangélico de Londrina, Londrina, PR, Brazil. OBJECTIVE: To assess clinical results of patients who underwent medial patellofemoral ligament (MPFL) reconstruction after a minimum of two years of follow-up. METHODS: Patients' medical records were assessed for residual instability, patient satisfaction, and post-operative functional outcomes. RESULTS: Fifty-one patients were analyzed, out of which 56.87% were women. Patients' mean age was 30.8 years (16 to 57 years). The mean follow-up time was 68.7 months (37 to 120 months). Length between first dislocation and surgery was less than 1 year for 58.82% of patients, between 1 and 5 years for 37.25%, and over 5 years for 3.93%. Patients showed a high degree of satisfaction (96.08% would undergo surgery again), with recurrence rate of 11.76%. Twenty-two patients reported knee symptoms, including pain from movements (72.72%), weakness (18.18%), constant pain (13.63%), and crepitus (4.54%). Considering dissatisfied patients, patients with dislocation recurrence, and patients with symptoms, five cannot practice physical activity, out of which only three blame their knee. CONCLUSION: MPFL reconstruction showed a recurrence rate of 11.7%, with high patient satisfaction, good functional results, and high rate of return to sports, after a minimum of two years of follow-up. Level of Evidence IV, Case Series. Publisher: OBJETIVO: Avaliar o resultado clínico de pacientes submetidos à reconstrução do ligamento patelofemoral medial (LPFM), acompanhados por mínimo de dois anos. MÉTODOS: Avaliação de prontuários para informações sobre instabilidade residual, satisfação do paciente e resultado funcional pós-operatório. RESULTADOS: Foram analisados 51 pacientes. 56,87% do sexo feminino e média etária 30,8 anos (16 a 57). Tempo médio de acompanhamento de 68,7 meses (37 a 120). Intervalo entre primeira luxação e cirurgia foi menos de 1 ano em 58,82%, entre 1 e 5 anos em 37,25% e mais de 5 anos para 3,93%. Os pacientes apresentaram alto grau de satisfação (96,08% fariam a cirurgia novamente), com 11,76% de recidiva. Houve persistência de sintomas em 22 pacientes, sendo dor ao movimento o principal (72,72%), seguido de fraqueza (18,18%), dor constante (13,63%) e crepitações (4,54%). Somando os pacientes insatisfeitos aos que tiveram recidiva da instabilidade e os sintomáticos, 5 não conseguem praticar atividade física, mas apenas 3 por causa do joelho. CONCLUSÃO: A reconstrução isolada do LPFM demonstrou índice de recidiva de 11,7%, com alto nível de satisfação dos pacientes, ótimos resultados funcionais e alta taxa de retorno ao esporte, em acompanhamento mínimo de 2 anos. Nível de Evidência IV, Série de Casos. DOI: 10.1590/1413-785220223003e241172 PMCID: PMC9150868