Isolated medial patellofemoral ligament reconstruction for recurrent patellofemoral instability: analysis of outcomes and risk factors.
Adolescent
Adult
Data Analysis
Databases, Factual
Female
Follow-Up Studies
Humans
Joint Instability
/ physiopathology
Ligaments, Articular
/ physiopathology
Male
Orthopedic Procedures
/ methods
Patellofemoral Joint
/ physiopathology
Range of Motion, Articular
Plastic Surgery Procedures
/ methods
Recurrence
Reoperation
/ statistics & numerical data
Risk Factors
Time Factors
Treatment Outcome
Young Adult
MPFL reconstruction
Patellofemoral instability
Risk factors
Journal
Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112
Informations de publication
Date de publication:
06 Apr 2021
06 Apr 2021
Historique:
received:
19
10
2020
accepted:
24
03
2021
entrez:
7
4
2021
pubmed:
8
4
2021
medline:
6
10
2021
Statut:
epublish
Résumé
The medial patellofemoral ligament (MPFL) is always damaged after patellar dislocation. In selected patients, MPFL reconstruction is necessary to restore a correct patellar tracking. Despite the large number of different techniques reported to reconstruct the MPFL, there is no consensus concerning the optimal procedure, and debates is still ongoing. The present study analysed the results after isolated MPFL reconstruction in patients with patellofemoral instability. Furthermore, a subgroup analysis of patients presenting pathoanatomical risk factors was made. In November 2020, the main electronic databases were accessed. All articles reporting the results of primary isolated MPFL reconstruction for recurrent patellofemoral instability were considered for inclusion. Only articles reporting a minimum 12-month follow-up were eligible. Data from a total of 1777 knees were collected. The mean age of the patients involved was 22.8 ± 3.4 years. The mean follow-up was 40.7 ± 25.8 months. Overall, the range of motion (+ 27.74; P < 0.0001) and all the other scores of interests improved at last follow-up: Kujala (+ 12.76; P = 0.0003), Lysholm (+ 15.69; P < 0.0001), Tegner score (+ 2.86; P = 0.006). Seventy-three of 1780 patients (4.1%) showed a positive apprehension test. Thirty of 1765 patients (1.7%) experienced re-dislocations, while 56 of 1778 patients (3.2%) showed persisting joint instability. Twenty-five of 1786 patients (1.4%) underwent revision surgeries. Isolated MPFL reconstruction for recurrent patellofemoral instability provides reliable surgical outcomes. Patients with pathoanatomical predisposing factors reported worse surgical outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
The medial patellofemoral ligament (MPFL) is always damaged after patellar dislocation. In selected patients, MPFL reconstruction is necessary to restore a correct patellar tracking. Despite the large number of different techniques reported to reconstruct the MPFL, there is no consensus concerning the optimal procedure, and debates is still ongoing. The present study analysed the results after isolated MPFL reconstruction in patients with patellofemoral instability. Furthermore, a subgroup analysis of patients presenting pathoanatomical risk factors was made.
METHODS
METHODS
In November 2020, the main electronic databases were accessed. All articles reporting the results of primary isolated MPFL reconstruction for recurrent patellofemoral instability were considered for inclusion. Only articles reporting a minimum 12-month follow-up were eligible.
RESULTS
RESULTS
Data from a total of 1777 knees were collected. The mean age of the patients involved was 22.8 ± 3.4 years. The mean follow-up was 40.7 ± 25.8 months. Overall, the range of motion (+ 27.74; P < 0.0001) and all the other scores of interests improved at last follow-up: Kujala (+ 12.76; P = 0.0003), Lysholm (+ 15.69; P < 0.0001), Tegner score (+ 2.86; P = 0.006). Seventy-three of 1780 patients (4.1%) showed a positive apprehension test. Thirty of 1765 patients (1.7%) experienced re-dislocations, while 56 of 1778 patients (3.2%) showed persisting joint instability. Twenty-five of 1786 patients (1.4%) underwent revision surgeries.
CONCLUSION
CONCLUSIONS
Isolated MPFL reconstruction for recurrent patellofemoral instability provides reliable surgical outcomes. Patients with pathoanatomical predisposing factors reported worse surgical outcomes.
Identifiants
pubmed: 33823887
doi: 10.1186/s13018-021-02383-9
pii: 10.1186/s13018-021-02383-9
pmc: PMC8022360
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
239Références
Am J Sports Med. 2004 Jul-Aug;32(5):1114-21
pubmed: 15262631
Knee Surg Sports Traumatol Arthrosc. 2013 Feb;21(2):279-93
pubmed: 23124628
J Orthop Surg Res. 2020 Oct 7;15(1):461
pubmed: 33028358
J Orthop Surg Res. 2012 Jun 06;7:21
pubmed: 22672660
Eur J Orthop Surg Traumatol. 2020 Jul;30(5):771-780
pubmed: 32048045
Arthroscopy. 2004 Feb;20(2):147-51
pubmed: 14760346
Acta Orthop Scand. 1988 Jun;59(3):336-41
pubmed: 3381671
Arch Orthop Trauma Surg. 2011 Aug;131(8):1059-65
pubmed: 21479862
Acta Orthop. 2005 Oct;76(5):699-704
pubmed: 16263618
Chin Med J (Engl). 2012 Jun;125(11):1884-8
pubmed: 22884047
Knee Surg Sports Traumatol Arthrosc. 2016 Mar;24(3):666-71
pubmed: 25416673
Rev Bras Ortop. 2016 Feb 06;51(2):187-93
pubmed: 27069888
Eur J Orthop Surg Traumatol. 2019 Oct;29(7):1579-1588
pubmed: 31123829
Knee Surg Sports Traumatol Arthrosc. 2017 Aug;25(8):2309-2320
pubmed: 26187008
J Bone Joint Surg Br. 2010 Oct;92(10):1376-80
pubmed: 20884974
Knee Surg Sports Traumatol Arthrosc. 2013 Sep;21(9):2147-54
pubmed: 23575650
Arthroscopy. 1993;9(2):159-63
pubmed: 8461073
Knee Surg Sports Traumatol Arthrosc. 2013 Feb;21(2):318-24
pubmed: 22538501
Biomed Res Int. 2013;2013:637678
pubmed: 24224173
Knee Surg Sports Traumatol Arthrosc. 2002 Jan;10(1):33-7
pubmed: 11819019
Am J Knee Surg. 1997 Fall;10(4):221-7
pubmed: 9421598
Rev Bras Ortop. 2015 Nov 16;46(6):675-83
pubmed: 27027072
J Orthop Surg Res. 2020 Mar 24;15(1):118
pubmed: 32209111
J Orthop Surg Res. 2014 Aug 15;9:66
pubmed: 25123919
Am J Sports Med. 2009 Sep;37(9):1735-42
pubmed: 19470945
Knee Surg Sports Traumatol Arthrosc. 2014 Oct;22(10):2470-6
pubmed: 24928369
Arthroscopy. 2016 Nov;32(11):2259-2268
pubmed: 27132780
Sports Med Arthrosc Rev. 2012 Sep;20(3):171-80
pubmed: 22878658
Eur J Orthop Surg Traumatol. 2019 Dec;29(8):1815-1822
pubmed: 31256290
Orthop Clin North Am. 2015 Jan;46(1):159-69
pubmed: 25435045
Knee. 2007 Dec;14(6):424-8
pubmed: 17933540
Phys Sportsmed. 2013 May;41(2):26-33
pubmed: 23703514
J Knee Surg. 2019 Feb;32(2):153-159
pubmed: 29514373
Knee. 2000 Dec 1;7(4):211-215
pubmed: 11104912
Open Orthop J. 2015 Jun 26;9:198-203
pubmed: 26161157
Am J Sports Med. 2011 Dec;39(12):2647-55
pubmed: 21868688
Arthroscopy. 1992;8(3):335-40
pubmed: 1418205
Am J Sports Med. 2015 Dec;43(12):2988-96
pubmed: 26435448
Am J Sports Med. 2013 Sep;41(9):2128-35
pubmed: 23925574
Knee Surg Sports Traumatol Arthrosc. 2014 Oct;22(10):2438-44
pubmed: 24584694
Eur J Orthop Surg Traumatol. 2020 Jul;30(5):763-770
pubmed: 32008097
Rev Bras Ortop. 2016 Apr 27;51(3):290-7
pubmed: 27274482
Sports Med Arthrosc Rev. 2017 Jun;25(2):92-99
pubmed: 28459752
Clin Orthop Relat Res. 1972;88:67-9
pubmed: 5086583
Arthroscopy. 2015 Jul;31(7):1372-80
pubmed: 25703288
Radiology. 1971 Oct;101(1):101-4
pubmed: 5111961
Acta Orthop. 2005 Oct;76(5):693-8
pubmed: 16263617
Am J Sports Med. 2007 Nov;35(11):1851-8
pubmed: 17724092
Indian J Orthop. 2012 Jul;46(4):447-54
pubmed: 22912521
Indian J Orthop. 2014 Sep;48(5):501-5
pubmed: 25298558
Knee. 2003 Sep;10(3):215-20
pubmed: 12893142
J Orthop Sci. 2008 Jan;13(1):32-8
pubmed: 18274853
Arch Orthop Trauma Surg. 2011 Mar;131(3):343-51
pubmed: 20714901
J Orthop Traumatol. 2016 Jun;17(2):155-62
pubmed: 26387113
Am J Sports Med. 2011 Jan;39(1):140-5
pubmed: 20929934
Clin Orthop Relat Res. 2008 Jun;466(6):1475-84
pubmed: 18347890
Open Access J Sports Med. 2017 Oct 09;8:189-203
pubmed: 29070955
Knee. 2014 Jan;21(1):21-7
pubmed: 23084729
Sports Med Arthrosc Rev. 2007 Mar;15(1):39-46
pubmed: 17301701
Surgeon. 2020 Oct 26;:
pubmed: 33121878
Chin Med J (Engl). 2010 Nov;123(21):3024-9
pubmed: 21162950
Am J Sports Med. 1982 May-Jun;10(3):150-4
pubmed: 6896798
Arthroscopy. 2013 May;29(5):891-7
pubmed: 23566568
J Knee Surg. 2014 Apr;27(2):139-46
pubmed: 24227396
Injury. 2015 Aug;46(8):1619-24
pubmed: 25916806
Am J Sports Med. 2014 Jul;42(7):1661-8
pubmed: 24758780
Rev Chir Orthop Reparatrice Appar Mot. 1982;68(5):317-25
pubmed: 6216535
Am J Sports Med. 2012 Jan;40(1):114-22
pubmed: 22016458
Knee Surg Sports Traumatol Arthrosc. 2014 Oct;22(10):2431-7
pubmed: 24154711
Injury. 2003 Aug;34(8):568-71
pubmed: 12892717
Arch Orthop Trauma Surg. 2020 Jun;140(6):769-776
pubmed: 32086557
Knee. 2014 Dec;21(6):1175-9
pubmed: 24927675
Am J Sports Med. 2000 Jul-Aug;28(4):472-9
pubmed: 10921637
J Orthop Surg Res. 2016 Nov 14;11(1):138
pubmed: 27842571
Am J Sports Med. 2013 May;41(5):1013-21
pubmed: 23524153
BMJ. 2009 Jul 21;339:b2535
pubmed: 19622551
Am J Sports Med. 2015 Apr;43(4):921-7
pubmed: 25587185
Arthroscopy. 2008 Apr;24(4):430-5
pubmed: 18375275
Rev Bras Ortop. 2018 Aug 20;53(5):570-574
pubmed: 30245996
Rev Chir Orthop Reparatrice Appar Mot. 1990;76(1):45-54
pubmed: 2140459
Knee Surg Sports Traumatol Arthrosc. 2005 Oct;13(7):516-21
pubmed: 15959766
Int Orthop. 1999;23(5):260-3
pubmed: 10653289
Arch Orthop Trauma Surg. 2020 Sep;140(9):1201-1210
pubmed: 32318817
Rev Bras Ortop. 2015 Dec 06;46(2):160-4
pubmed: 27027005
Clin Orthop Surg. 2015 Dec;7(4):457-64
pubmed: 26640628
Arthrosc Tech. 2018 Jan 15;7(2):e113-e123
pubmed: 29552477
Am J Sports Med. 2006 Aug;34(8):1254-61
pubmed: 16567459
Am J Sports Med. 2015 Jan;43(1):186-94
pubmed: 25367019
Knee Surg Sports Traumatol Arthrosc. 1994;2(1):19-26
pubmed: 7584171
J Orthop Surg Res. 2017 Feb 13;12(1):29
pubmed: 28193295
Arthroscopy. 2016 Jul;32(7):1421-7
pubmed: 27032603
Arthroscopy. 2008 Jan;24(1):82-7
pubmed: 18182207
Am J Sports Med. 1986 Mar-Apr;14(2):117-20
pubmed: 3717480
Orthop J Sports Med. 2017 Feb 07;5(2):2325967116687749
pubmed: 28210659
Knee. 2011 Oct;18(5):333-9
pubmed: 20719519