Postoperative Bracing after Medial Patellofemoral Ligament Reconstruction.

Autor:	Schaver AL; Department of Orthopedic Surgery, Marshall University, Huntington, West Virginia., Tranovich MA; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa., O'Reilly OC; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa., Bollier MJ; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa., Duchman KR; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa., Wolf BR; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa., Westermann RW; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa.
Jazyk:	angličtina
Zdroj:	The journal of knee surgery [J Knee Surg] 2024 Jul; Vol. 37 (9), pp. 631-637. Date of Electronic Publication: 2023 Dec 19.
DOI:	10.1055/a-2232-4856
Abstrakt:	It is unclear if bracing is necessary after isolated medial patellofemoral ligament reconstruction (MPFLr) for recurrent patellar instability. We hypothesize that patients who did not use a brace will have similar outcomes to those who were braced postoperatively. A retrospective review of patients who underwent isolated MPFLr from January 2015 to September 2020 at a single institution was performed. Those with less than 6 weeks of follow-up were excluded. The braced group was provided a hinged-knee brace postoperatively until the return of quadriceps function, which was determined by the treating physical therapist (brace, "B"; no brace, "NB"). Time to straight leg raise (SLR) without lag, recurrent instability, and total re-operations were determined. Univariate analysis and logistic regression were used to evaluate outcomes (statistical significance, p  < 0.05). Overall, 229 isolated MPFLr were included (B: 165 knees, 146 patients; NB: 64 knees, 58 patients). Baseline demographics were similar (all p  > 0.05). Median time to SLR without lag was shorter in the NB group (41 days [interquartile range [IQR]: 20-47] vs. 44 days [IQR: 35.5-88.3], p  = 0.01), while return to sport times were equivalent (B: 155 days [IQR: 127.3-193.8] vs. NB: 145 days [IQR: 124-162], p  = 0.31). Recurrent instability rates were not significantly different (B: 12 knees [7.27%] vs. NB: 1 knee [1.56%], p  = 0.09), but the re-operation rate was higher in the brace group (20 knees [12.1%] vs. 0 [0%], p  = 0.001). Regression analysis identified brace use (odds ratio [OR]: 19.63, 95% confidence interval [CI]: 1.43-269.40, p  = 0.026) and female patients (OR: 2.79, 95% CI: 1.01-7.34, p  = 0.049) to be associated with needing reoperation. Recurrent instability rates and return to sport times were similar between patients who did or did not use a hinged knee brace after isolated MPFLr. Re-operation rates were higher in the braced group. Retrospective Comparative Study, Level III. Competing Interests: None declared. (Thieme. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu