Isolated medial patellofemoral ligament reconstruction improves static bipedal balance control in young patients with recurrent lateral patellar instability.


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:
12 Oct 2023
Historique:
received: 11 08 2023
accepted: 08 10 2023
medline: 1 11 2023
pubmed: 13 10 2023
entrez: 12 10 2023
Statut: epublish

Résumé

Knee stability can be safely and reliably restored using medial patellofemoral ligament (MPFL) reconstruction, which is widely recognized in patients with recurrent lateral patellar instability. However, the literature regarding its influence on static balance control is limited. Thus, this study aimed to assess the impact of MPFL reconstruction on balance control and determine its functional significance. The study comprised 26 patients with recurrent lateral patellar instability, scheduled for MPFL reconstruction, and 26 matched healthy controls who underwent double-leg stance static posturographic tests pre- and postoperatively on a vertical force platform. Four test conditions were performed with their eyes open and closed, without and with foam support to evaluate the balance control of all participants. The International Knee Documentation Committee subjective knee form, Lysholm knee scoring scale, Tampa scale for kinesiophobia, and active range of motion of the affected knee were synchronously obtained and assessed. More postural sway was observed in patients compared to the healthy controls, 11 ± 5 days preoperatively (p < 0.01). However, 374 ± 23 days postoperatively, postural sway between the patients and control subjects was comparable (p > 0.05). Patients following MPFL reconstruction demonstrated better postural stability (p < 0.01). Significant ameliorations were found in all clinical assessments in the study patients postoperatively (p < 0.01). Patients with recurrent lateral patellar instability have inefficient balance control. Static bipedal balance control can be improved under surface perturbation in these patients one year after isolated MPFL reconstruction that enhances the possibility of normal restoration of postural stability. Structural recovery of the ligament could help restore the sensorimotor efficiency and generate the compensatory and anticipatory balance regulation strategies, thereby improving joint function.

Sections du résumé

BACKGROUND BACKGROUND
Knee stability can be safely and reliably restored using medial patellofemoral ligament (MPFL) reconstruction, which is widely recognized in patients with recurrent lateral patellar instability. However, the literature regarding its influence on static balance control is limited. Thus, this study aimed to assess the impact of MPFL reconstruction on balance control and determine its functional significance.
METHODS METHODS
The study comprised 26 patients with recurrent lateral patellar instability, scheduled for MPFL reconstruction, and 26 matched healthy controls who underwent double-leg stance static posturographic tests pre- and postoperatively on a vertical force platform. Four test conditions were performed with their eyes open and closed, without and with foam support to evaluate the balance control of all participants. The International Knee Documentation Committee subjective knee form, Lysholm knee scoring scale, Tampa scale for kinesiophobia, and active range of motion of the affected knee were synchronously obtained and assessed.
RESULTS RESULTS
More postural sway was observed in patients compared to the healthy controls, 11 ± 5 days preoperatively (p < 0.01). However, 374 ± 23 days postoperatively, postural sway between the patients and control subjects was comparable (p > 0.05). Patients following MPFL reconstruction demonstrated better postural stability (p < 0.01). Significant ameliorations were found in all clinical assessments in the study patients postoperatively (p < 0.01).
CONCLUSIONS CONCLUSIONS
Patients with recurrent lateral patellar instability have inefficient balance control. Static bipedal balance control can be improved under surface perturbation in these patients one year after isolated MPFL reconstruction that enhances the possibility of normal restoration of postural stability. Structural recovery of the ligament could help restore the sensorimotor efficiency and generate the compensatory and anticipatory balance regulation strategies, thereby improving joint function.

Identifiants

pubmed: 37828531
doi: 10.1186/s13018-023-04272-9
pii: 10.1186/s13018-023-04272-9
pmc: PMC10571255
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

771

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

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Auteurs

Fenghua Tao (F)

Department of Orthopedics, Renmin Hospital of Wuhan University, 238, Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China.

Hai Tao (H)

Department of Orthopedics, Renmin Hospital of Wuhan University, 238, Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China.

Lin Jin (L)

Department of Orthopedics, Renmin Hospital of Wuhan University, 238, Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China.

Haijun Gao (H)

Department of Emergency, Renmin Hospital of Wuhan University, Wuhan, China.

Yue Luo (Y)

Department of Orthopedics, Renmin Hospital of Wuhan University, 238, Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China.

Zheng Zhang (Z)

Department of Orthopedics, Renmin Hospital of Wuhan University, 238, Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China. zhangzheng_fr@126.com.

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