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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-02-2013 | Knee

The influence of risk factors on clinical outcomes following anatomical medial patellofemoral ligament (MPFL) reconstruction using the gracilis tendon

Authors: Daniel Wagner, Florian Pfalzer, Swen Hingelbaum, Jochen Huth, Frieder Mauch, Gerhard Bauer

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2013

Abstract

Purpose

Patellofemoral instability is influenced by ligamentous, boney and neuromuscular factors. The most important variables are trochlea geometry, medial patellofemoral ligament (MPFL), patella height, tibial tuberosity–trochlea groove distance (TT–TG) and the extensor muscles. Treatment is complicated by these multifactorial conditions. This prospective study examined the influence of risk factors on clinical results and athletic activities where treatment was confined to ligamentous procedures only.

Methods

Fifty patients with chronic patellofemoral instability were treated with MPFL reconstruction using an autologous gracilis tendon. Clinical data, radiographs and magnetic resonance imaging (MRI) were prospectively evaluated pre- and postoperative (minimum follow-up 12 month) to detect existing risk factors for patellofemoral instability and to evaluate clinical and sport ability scores (Kujala, Valderrabano).

Results

There was a low rate of redislocation (2 %) and an average Kujala score of 87 ± 13 points postoperative. The MRI showed good integration of the reconstructed MPFL and a positive effect regarding the decrease of patella tilt (16.1° to 11.2°). A negative relationship was found between the degree of trochlear dysplasia and outcomes. 80 % of all patients returned to the same or higher level of physical activity.

Conclusions

Addressing only ligamentous factors through MPFL reconstruction leads to satisfying clinical results and low redislocation rates in most patients. In cases with a high degree of trochlear dysplasia and enlarged TT–TG, additional procedures such as trochleaplasty and tibial tuberosity transfer should be considered as well.

Level of evidence

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Title: The influence of risk factors on clinical outcomes following anatomical medial patellofemoral ligament (MPFL) reconstruction using the gracilis tendon
Authors: Daniel Wagner
Florian Pfalzer
Swen Hingelbaum
Jochen Huth
Frieder Mauch
Gerhard Bauer
Publication date: 01-02-2013
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-012-2015-5

At a glance: The STEP trials

Springer Medicine

The influence of risk factors on clinical outcomes following anatomical medial patellofemoral ligament (MPFL) reconstruction using the gracilis tendon

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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