Postoperative Bracing After Medial Patellofemoral Ligament Reconstruction.

Postoperative Bracing After Medial Patellofemoral Ligament Reconstruction Abstract Introduction: It is unclear if bracing is necessary after isolated medial patellofemoral ligament reconstruction (MPFLr) for recurrent patellar instability. We hypothesize that patients who did not use a brace will have similar outcomes to those who were braced postoperatively. A retrospective review of patients who underwent isolated MPFLr from January 2015 to September 2020 at a single institution was performed. Those with less than 6 weeks follow-up were excluded. The braced group was provided a hinged-knee brace postoperatively until return of quadriceps function, which was determined by the treating physical therapist (Brace, "B"; No Brace, "NB"). Time to straight leg raise without lag, recurrent instability, and total re-operations were determined. Univariate analysis and logistic regression were used to evaluate outcomes (statistical significance, p<0.05). Overall, 229 isolated MPFLr were included (B: 165 knees, 146 patients; NB: 64 knees, 58 patients). Baseline demographics were similar (all p>0.05). Median time to straight leg raise without lag was shorter in the NB group (41 days [IQR, 20-47] vs. 44 days [IQR, 35.5-88.3], p=0.01), while return to sport times were equivalent (B 155 days [IQR, 127.3-193.8] vs. NB 145 days [IQR, 124-162], p=0.31). Recurrent instability rates were not significantly different (B 12 knees [7.27%] vs. NB 1 knee [1.56%], p=0.09), but the re-operation rate was higher in the brace group (20 knees [12.1%] vs. 0 [0%], p=0.001). Regression analysis identified brace use (OR 19.63, 95%CI 1.43-269.40, p=0.026) and female patients (OR 2.79, 95%CI 1.01-7.34, p=0.049) to be associated with needing reoperation. Recurrent instability rates and return to sport times were similar between patients who did or did not use a hinged knee brace after isolated MPFLr. Re-operation rates were higher in the braced group. Retrospective Comparative Study, Level III Key Terms: Patellar instability, MPFL reconstruction, bracing, rehabilitation.

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The authors declare that they have no conflict of interest.