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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2017

01-08-2017 | Knee

Surgical treatment of patellofemoral instability using trochleoplasty or MPFL reconstruction: a systematic review

Authors: Enrique Adrian Testa, Carlo Camathias, Felix Amsler, Philipp Henle, Niklaus F. Friederich, Michael Tobias Hirschmann

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2017

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Abstract

Purpose

Trochleoplasty and reconstruction of the medial patellofemoral ligament (MPFL) are among the most commonly performed surgical treatments in patients with patellofemoral instability. The primary purpose of the study was to perform a systematic literature review on trochleoplasty in the treatment of patients with patellofemoral instability. The secondary purpose was to compare the outcomes with those seen in patients treated after reconstruction of the MPFL.

Methods

A standardised search on search engines was performed. All observational and experimental studies dealing with trochleoplasty were then obtained and reviewed in a consensus meeting. Fifteen articles out of 1543 were included and analysed using the CASP appraisal scoring system. Twenty-five studies on MPFL reconstruction were obtained for comparison. The clinical and radiological outcomes were statistically analysed.

Results

Both treatment groups showed significant improvement in outcomes from pre- to post-operatively. The mean post-operative Kujala and the Lysholm scores significantly increased in both groups when compared to preoperatively (trochleoplasty group: Kujala 61.4–80.8 and Lysholm 55.5–78.5; MPFL group: Kujala 46.9–88.8 and Lysholm 59.9–91.1). Post-operatively a positive apprehension test was found in 20 and 8 % of the trochleoplasty and MPFL groups, respectively. No significant differences in redislocation (2 %) and subluxation (5–6 %) rates were found.

Conclusions

This systematic review showed that both trochleoplasty and MPFL reconstruction are able to deliver good clinical outcomes with stable patellofemoral joints.

Level of evidence

III.
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Metadata
Title
Surgical treatment of patellofemoral instability using trochleoplasty or MPFL reconstruction: a systematic review
Authors
Enrique Adrian Testa
Carlo Camathias
Felix Amsler
Philipp Henle
Niklaus F. Friederich
Michael Tobias Hirschmann
Publication date
01-08-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3698-1

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