Concomitant Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Osteotomy Do Not Increase the Incidence of 30-Day Complications: An Analysis of the NSQIP Database.

BACKGROUND

Lateral patellar dislocations account for 2% to 3% of total knee injuries, especially in adolescents. Depending on the anatomic abnormality contributing to lateral patellar instability, medial patellofemoral ligament reconstruction (MPFLR) and/or tibial tubercle osteotomy (TTO) may be indicated.

PURPOSE

To assess the risk of adverse events (AEs) after TTO, MPFLR, and concomitant MPFLR and TTO.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

Patients who underwent MPFLR, TTO, and concomitant MPFLR and TTO between 2005 and 2016 were identified through the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database. Medical complications (eg, surgical site infection and deep vein thrombosis), readmission rates, and extended hospital stay within 30 days of the procedure were recorded. Outcomes were compared with bivariate and multivariate Poisson regression.

RESULTS

Out of 882 patients, 617 (70.0%) underwent isolated MPFLR, 170 (19.3%) underwent TTO, and 95 (10.8%) underwent concomitant MPFLR and TTO. The operative time for concomitant MPFLR and TTO was significantly longer (122 ± 45 minutes) compared with isolated MPFLR (97 ± 55 minutes;

CONCLUSION

While concomitant MPFLR and TTO significantly increased operative time, there was no difference in the rate of AEs, extended hospital stay, and readmissions within 30 days after isolated MPFLR, isolated TTO, and concomitant MPFLR and TTO.

Déclaration de conflit d'intérêts

One or more of the authors has declared the following potential conflict of interest or source of funding: A.B.Y. has received research support from NuTech and Arthrex; educational support from Medwest, Arthrex, and Smith & Nephew; and consulting fees from Aastrom Biosciences and JRF Ortho. N.N.V. has received research support from Arthrex, Arthrosurface, DJ Orthopaedics, Ossur, Athletico, ConMed Linvatec, MioMed, and Mitek; educational support from Medwest; royalties from Arthroscopy, Smith & Nephew, and Vindico Medical Education–Orthopedics Hyperguide; consulting fees from Arthrex, Medacta, Minivasive, OrthoSpace, and Smith & Nephew; nonconsulting fees from Pacira Pharmaceuticals; and stock options from CyMedica, Minivasive, and Omeros. B.F. has received research support from Arthrex and Stryker; honoraria from Arthrosurface; educational support from Medwest, Smith & Nephew, and Ossur; consulting fees from Sonoma Orthopedics and Stryker; royalties from Elsevier; and stock options from Jace Medical. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.