Anatomical medial patellofemoral ligament reconstruction improves sport participation and activity levels in adolescents with recurrent patellar dislocation

Abstract

Objectives: This study aims to evaluate the clinical outcomes of an anatomical medial patellofemoral ligament (MPFL) reconstruction and the effects of concomitant patellofemoral joint injuries and radiological findings on outcomes in adolescents with recurrent patellar dislocation (RPD).

Patients and methods: Between January 2011 and January 2020, a total of 34 patients (19 males, 15 females; median age: 15.6 years; range, 13 to 17 years) with RPD who underwent anatomic MPFL reconstruction were retrospectively analyzed. Lateral release was performed as indicated. Clinical outcomes were evaluated preoperatively and at the final follow-up using the Visual Analog Scale (VAS), Lysholm, Kujala, and Tegner activity rating scales. Magnetic resonance imaging was performed to detect concomitant injuries such as bone, cartilage, and soft tissue injuries.

Results: The mean follow-up was 5±2 years. All postoperative knee functions and activity levels were statistically significantly improved without re-dislocation (p<0.001). There was no statistically significant relationship between the presence and location of cartilage lesions and clinical outcomes (p>0.05). Patients with cartilage lesions had a significantly higher CatonDeschamps index and a higher incidence of bone edema in both the patella and femur than patients without.

Conclusion: Anatomic MPFL reconstruction with meticulous physical therapy has successful clinical outcomes, prevents re-dislocation, and increases participation in sports and activity levels in adolescent patients with RPD. Although cartilage injuries are common after RPD, it has no adverse effect on clinical outcomes in the mid-term.

Citation: Örs Ç, Çaylak R, Karataş Ö, Sarpel Y. Anatomical medial patellofemoral ligament reconstruction improves sport participation and activity levels in adolescents with recurrent patellar dislocation. Jt Dis Relat Surg 2024;35(3):674-683. doi: 10.52312/jdrs.2024.1518.

The study protocol was approved by the Çukurova University Faculty of Medicine Non-Interventional Clinical Research Ethics Committee (date: 04.0.3.2022, no: 120/40/07.04.2022). The study was conducted in accordance with the principles of the Declaration of Helsinki.

A written informed consent was obtained from the parents and/or legal guardians of the patients.

Idea/concept, design, control/ supervision, analysis and/or interpretation, materials: C.O.; Data collection and/or processing: C.O., Y.S.; Literature review, writing the article: C.O., O.K., R.C.; Critical review: Y.S.; References and fundings: C.O., O.K.; Other: R.C., O.K.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.

The data that support the findings of this study are available from the corresponding author upon reasonable request.