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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2014

01-10-2014 | Knee

Clinical outcome after medial patellofemoral ligament reconstruction and autologous chondrocyte implantation following recurrent patella dislocation

Authors: Rainer Siebold, Georgios Karidakis, Francis Fernandez

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2014

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Abstract

Purpose

Medial patellofemoral ligament (MPFL) reconstruction is a well-established treatment option in recurrent patella dislocation. The combination with associated retropatellar cartilage lesions are severe injuries and very difficult to treat. The purpose of this study was to evaluate our clinical results of MPFL reconstruction and autologous chondrocyte implantation (ACI).

Methods

Thirteen patients with recurrent patella dislocation were treated with a combination of MPFL reconstruction and ACI at our institution between 2010 and 2014. All patients had at least 2 patella dislocations. The posttraumatic cartilage lesions were grade IV according to the ICRS and were localized retropatellar in 8 cases and at the lateral femoral condyle in 2 cases. The mean defect size was 7.2 ± 3.5 cm2 (3–12 cm2). Subjective and objective scores were assessed before surgery and at f/u, as well as radiologic parameters and cartilage status on magnetic resonance imaging (MRI).

Results

Ten patients (5 male, 5 female) with a mean follow-up of 2 years (minimum 1 year to 4 years) were enrolled in the study. At latest clinical follow-up, all patients had a stable patella with no signs of instability and all patients showed improved subjective and objective scores. Lysholm score increased to 74.1 ± 18.7 (48–99), KOOS score to 74.4 ± 16.9 (57–95), IKDC subjective to 63.9 ± 22.1 (34–93) and Kujala score to 73.8 ± 25.1 (50–100). The post-operative modified MOCART score for quality assessment of the ACI on MRI was an average of 13.7 ± 1.8 points (11–16), with a complete fill of the defect in 80 % of lesions.

Conclusion

Medial patellofemoral ligament reconstruction with simultaneous ACI showed good clinical results in recurrent patella dislocation with traumatic cartilage lesions grade IV. No patella re-dislocation occurred and the ACI was successful in 80 % of patients according to MRI. Subjective and objective scores improved but combined surgery is inferior to reports from the literature on MPFL reconstruction alone without cartilage damage.

Level of evidence

Therapeutic case series, Level IV.
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Metadata
Title
Clinical outcome after medial patellofemoral ligament reconstruction and autologous chondrocyte implantation following recurrent patella dislocation
Authors
Rainer Siebold
Georgios Karidakis
Francis Fernandez
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3196-x

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