Medial capsule reefing in patellar instability

The efficacy of medial capsule reefing in the treatment of patellar instability is well documented. Aim of the present study was to prospectively evaluate the outcomes of an all-arthroscopic medial capsule reefing technique in young patients with painful patella syndrome and potential patellar instability.

Thirty patients with painful patellar syndrome and potential patellar instability having undergone a minimum of 6 months of intensive rehabilitation were enrolled in the present study. All subjects were evaluated with physical examination, clinical and functional outcomes and complete imaging study.

All patients were reviewed at an intermediate follow-up of 72 months. Average Kujala score improved from 72.9 ± 15.0 to 88.4 ± 7.6 (p < 0.0001), average Larsen score from 15.0 ± 2.5 to 17.2 ± 2.2 (p < 0.002), average Lysholm from 63.8 ± 16.7 to 87.9 ± 11.7 (p < 0.0001) and average Fulkerson score from 69.5 ± 21.5 to 90.8 ± 9.8 (p < 0.0001). No intraoperative or postoperative complications were recorded. Ninety per cent of patients were very satisfied or satisfied with their functional result. Twenty-eight patients were reviewed at the final follow-up, 120 months after surgery. Average Kujala was 87.7 ± 8.8 (p < 0.0001), average Larsen was 16.8 ± 2.7 (p < 0.01), average Lysholm was 87.6 ± 14.3 (p < 0.0001), and average Fulkerson was 87.2 ± 13.9 (p < 0.0001). Almost 86 % of patients were very satisfied or satisfied with their result. However, slight deterioration of the outcomes over time was observed.

At the final follow-up, the outcomes of all-arthroscopic technique were significantly improved from preoperative values; however, they were slightly inferior at the 72 months follow-up. This slight deterioration of the outcomes may be the consequence of the reduction in physical activities.

Case series, Level IV.