Medial patellotibial ligament (MPTL) reconstruction for patellar instability
| Autor: | Alberto Grassi, Vittorio Vaccari, Andrea Benzi, William F. Luetzow, Maurilio Marcacci, Giulio Maria Marcheggiani Muccioli, Stefano Zaffagnini |
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| Přispěvatelé: | Zaffagnini, Stefano, Grassi, Alberto, Marcheggiani Muccioli, Giulio M.aria, Luetzow, William F., Vaccari, Vittorio, Benzi, Andrea, Marcacci, Maurilio |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
musculoskeletal diseases
Adult Joint Instability Male medicine.medical_specialty Medial patellotibial ligament Adolescent Knee Joint Radiography medicine.medical_treatment Patellar Dislocation Pain Arthroplasty Young Adult Patellar Ligament Retrospective Studie medicine Humans Reconstructive Surgical Procedure Orthopedics and Sports Medicine In patient Treatment Failure Child Retrospective Studies Orthodontics business.industry Patellar ligament Medicine (all) Patella Plastic Surgery Procedures musculoskeletal system respiratory tract diseases medicine.anatomical_structure Treatment Outcome Orthopedic surgery Surgery Female business human activities Human |
| Popis: | To evaluate mid-term clinical and radiographic outcomes after an original medial patellotibial ligament reconstruction in patients with patellar dislocation. METHODS: Twenty-nine knees (27 patients, 8 males and 19 females) treated for patellar dislocation with medialization of the patellar tendon medial third combined with medial and lateral release were evaluated clinically and radiographically at a mean follow-up of 6.1±2.5 years. Trochleoplasty was performed in case of severe flat trochlea (6 knees, 21%). Aetiology of patellofemoral instability was traumatic in 6 (21%) and atraumatic in 23 (79%) knees. The mean age at first dislocation was 19.2±10.1 years. WOMAC, subjective and objective IKDC, Kujala, VAS for pain, Tegner activity and EQ-5D scores were used. Anteroposterior, lateral and 30° axial views were performed for radiographic monitoring. RESULTS: There was a significant improvement of all clinical scores and significant reduction in knee pain. Twenty-four knees (83%) were normal or nearly normal by objective IKDC score at final follow-up. Radiographs showed a higher incidence of patella alta and flat trochlea in the atraumatic group. Severe signs of patellar osteoarthritis were found in 1 knee (3%). A higher body mass index (BMI) was correlated with worse pre-operative scores. Four knees (14%) were considered failures (2 further dislocations, 2 revision surgeries). The overall survival rate at 6 years was 0.811. CONCLUSIONS: The presented techniques produced good clinical and radiographic results at mean 6.1 years follow-up, with 14 % failures. Signs of patellofemoral dysplasia were found in patients with atraumatic patellar dislocation. BMI was related to worse pre-operative clinical status. LEVEL OF EVIDENCE: Retrospective study, Level IV. |
| Databáze: | OpenAIRE |
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