Original surgical technique for the treatment of patellofemoral instability after failure of conservative treatment - 25/10/24
Abstract |
Introduction |
Acute patellar dislocation is a common but serious injury that can significantly impact a patient's functional prognosis. The objective of this retrospective study is to evaluate the clinical outcomes of arthroscopic medial patellofemoral ligament (MPFL) reconstruction and plication of the medial patellar retinaculum using suture anchors in adolescent patients with first-time acute patellar dislocation (APD) and MPFL insertion injury.
Hypothesis |
Tightening repair of the medial retinaculum complex can result in favorable clinical and functional outcomes in this patient population.
Materials and methods |
A total of 84 adolescent patients with first-time APD and with an average age of 15.5 years (10-22) were included in the study. Of these patients, 61 (7 male and 54 female) underwent arthroscopic suture anchor plication for medial patellar retinaculum, while the other 23 were successfully treated non-operatively. Radiographic outcomes, including the congruence angle (CA), lateral patellofemoral angle (LPA), and patellar tilt angle (PTA), were evaluated preoperatively and at the last follow-up visit in the surgical group. Functional outcomes were assessed using the Lille Patello-Femoral Score, Lysholm Score, and Kujala Score at the same time points. In addition, the surgical and non-operative treatment success groups were compared in terms of both radiographic and functional outcomes.
Results |
Mean follow-up was 40.9 months (24–60). Fifty-nine knees showed excellent or good results postoperatively, 2 patients had a recurrent patellar subluxation. The Lille Patello-Femoral Score was 96.9±4.7 at the last follow-up. The subjective Lysholm Score and Kujala Score improved significantly, from 58.6 to 91.9 and from 60.4 to 88.9, respectively. The radiographic CA, LPA and PTA improved significantly, from 19.8±2.1° to –6.7±1.7°, from –7.4±2.2° to 5.7±1.8° and from 23.8±2.9° to 12.3±2.3°, respectively. There was no statistically significant difference in functional and radiographic assessments between the success with non-operative treatment group and the surgery group.
Conclusion |
The results of this study suggest that arthroscopic MPFL insertion reconstruction and plication using suture anchors, which is less invasive and improves patella stability, can lead to favorable clinical and functional outcomes in adolescent patients with first-time acute patellar dislocation and insertion injury. This treatment approach should be considered as a viable option for this patient population.
Level of evidence |
IV; monocentric retrospective descriptive study.
Le texte complet de cet article est disponible en PDF.Keywords : First acute patellar dislocation, Medial retinaculum, Medial patellofemoral ligament, Lateral release, Arthroscopy, Suture anchor
Plan
Vol 110 - N° 7
Article 103657- novembre 2024 Retour au numéro
Article précédent
- Minimally invasive surgery of femoral periprosthetic fractures increases the rate of consolidation and decreases time to bone healing without a higher rate of complications
- Marie Le Baron, Thibaut Battut, Thierry Bégué, Matthieu Ehlinger, Xavier Flecher, SOFCOT
- MPFL reconstruction with proximal rather than distal femoral tunnel position leads to less favorable short-term results
- Kyoung Ho Yoon, Bi O. Jeong, Sung Hyun Hwang, Jin Hyung Kim, Yoon Seok Kim, Hee Sung Lee
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?