Acute and recurrent patellar instability in the young athlete.

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Abstract

[Indexed for MEDLINE] 14. J Knee Surg. 2014 Apr;27(2):139-46. doi: 10.1055/s-0033-1360652. Epub 2013 Nov 13. Medial patellofemoral ligament (MPFL) reconstruction for the treatment of patellofemoral instability. Csintalan RP(1), Latt LD(2), Fornalski S(3), Raiszadeh K(4), Inacio MC(5), Fithian DC(4). Author information: (1)Department of Orthopedics, Southern California Permanente Medical Group, Orange County, Irvine, California. (2)Department of Orthopedic Surgery, University of Arizona, Tuscon, Arizona. (3)Department of Orthopedic Surgery, Kaiser Permanente, Irvine, California. (4)Department of Orthopedic Surgery, Kaiser Permanente, San Diego, California. (5)Department of Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, California. Patellofemoral instability can be a disabling problem. Numerous techniques are employed for its treatment. Medial patellofemoral ligament (MPFL) reconstruction in combination with other procedures has been explored by many orthopedic surgeons. The purpose of the study was to determine the effectiveness of isolated MPFL reconstruction in treating the symptoms associated with patellofemoral instability, preventing recurrence of patella dislocation, and returning patients to preinjury level of activity. This is a case series study. We conducted a clinical follow-up study on 56 knees (49 patients) after MPFL reconstruction for recurrent patellar instability with a mean follow-up of 4.3 years (range, 1.1-6.8). A single MPFL reconstruction technique was performed in all cases. Patient outcomes were evaluated using: International Knee Documentation Committee (IKDC) subjective knee form, Tegner activity score, functional hop test, and radiographs. Mean age at time of surgery was 24 years old (range, 13-49). Females comprised 75% of the sample. Mean interval from injury to surgery was 7.2 ± 8.6 years (range, 51 days-37 years). At follow-up, there were no recurrent dislocations reported, patella subluxation in 6 (11%) cases, and radiographic degenerative changes were none to mild in all patients. The series mean IKDC scores at follow-up was 76.3 ± 19.2 (range, 30-99), and Tegner activity scores were 5.6 ± 2.5. MPFL reconstruction is an option for treating the symptoms of patellar instability, preventing recurrent dislocation, and returning patients near to their preinjury level of activity. The level of evidence is IV. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA. DOI: 10.1055/s-0033-1360652