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Aim The goal of this project was to evaluate the outcomes associated with Medial Patellofemoral Ligament plication for the treatment of Chronic Patella dislocations and Refractory Patellofemoral Syndrome. Abstract Background: Anterior knee pain accounts for 25-40% of knee pain visits in sports medicine clinics. Refractory Patellofemoral Syndrome (RPS) and Chronic Patella Dislocations are often multifactorial but commonly the pain originates from impaired patellar tracking and increased lateral patellar tilt. The compression of the subchondral bone has been correlated to the pain as well as from the synovium, retinaculum, and associated neuromuscular structures. The plication of the Medial Patellofemoral Ligament (MPFL) counteracts these compressive and tilting forces improving symptoms of RPS and recurrent patella dislocations. The goal of this project was to evaluate the outcomes associated with MPFL plication. Study Design: Case Series; Level IV Methods: A retrospective analysis of patients with recurrent patella dislocations, Refractory Patellofemoral Syndrome (RPS) or Patellofemoral Pain Syndrome (PFPS) treated with plication of the MPFL between 2009 - 2018 with minimum four month follow up. The primary outcome variable was patient overall satisfaction, Visual Analogue Scale for Pain (VAS) and Kujala (Anterior Knee Pain) Score. Results Seven patients met the inclusion criteria. Their demographic and pre-surgery details are in Table 1. A large majority of patients (85.7%) were satisfied, and VAS pain scale ratings were four or less. Only one of the seven patients was not satisfied (Table 2), and that individual also had the lowest Kujala score. The VAS pain scale and the Kujala score were not correlated (Spearman rank correlation, rho=-0.218, P=0.638; Figure 1), nor was there a clear relationship between time since surgery and Kujala score (rho=0.607, P=0.167; Figure 2). Conclusion: Plication of the MPFL has a high success in improving both Kujala (Anterior Knee Pain) Score and Visual Analogue Scale (VAS) as well as return to regular activities. We believe this is a safe and effective technique in improving chronic patella dislocations and Refractory Patellofemoral Syndrome with minimal perioperative morbidity. |
