Medial patellofemoral ligament reconstruction fails to correct mild patella alta in cases of patellofemoral instability—a case-control study

Purpose Medial patellofemoral ligament reconstruction (MPFL-R) is the gold standard in patella soft tissue surgery for patellofemoral instability. Although claimed, recent reports indicate that MPFL-R may fail to distalize the patella in mild cases of patella alta. The present study is a retrospecti...

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Bibliographic Details
Published in:International orthopaedics 2019-09, Vol.43 (9), p.2071-2075
Main Authors: Roessler, Philip P., Wimmer, Matthias D., Jacobs, Cornelius, Bornemann, Rahel, Stein, Thomas, Lahner, Matthias
Format: Article
Language:English
Subjects:
Adult
Case-Control Studies
Female
Humans
Joint Instability - diagnostic imaging
Joint Instability - etiology
Joint Instability - surgery
Ligaments, Articular - surgery
Male
Medicine
Medicine & Public Health
Original Paper
Orthopedics
Patella - abnormalities
Patella - diagnostic imaging
Patella - surgery
Patellar Dislocation - diagnostic imaging
Patellar Dislocation - etiology
Patellar Dislocation - surgery
Patellofemoral Joint - diagnostic imaging
Patellofemoral Joint - injuries
Patellofemoral Joint - surgery
Reconstructive Surgical Procedures - adverse effects
Reproducibility of Results
Retrospective Studies
Young Adult
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Summary:Purpose Medial patellofemoral ligament reconstruction (MPFL-R) is the gold standard in patella soft tissue surgery for patellofemoral instability. Although claimed, recent reports indicate that MPFL-R may fail to distalize the patella in mild cases of patella alta. The present study is a retrospective case-control study to compare radiographic patella height between MPFL-R and historical Insall’s proximal realignment (IPR) pre- and post-operatively with respect to distalization and assess redislocation rates at a mid-term follow-up. Methods Sixty-four patients were age/sex matched (1:1), yielding 32 patients for group 1 MPFL-R (cases) and 32 patients for group 2 IPR (controls). Insall-Salvati, Blackburne-Peel and Caton-Deschamps indices were analyzed for differences pre- and post-operatively. An additional inter-rater reliability analysis was performed by means of intra-class correlation (ICC). Redislocation rates were considered as treatment failures in this study. Results ICC was excellent for all three patella indices. MPFL-R failed to show significant differences if compared to IPR with respect to distalization in mild stages of patella alta. Moreover, redislocation rates significantly favored MPFL-R (3.1%) over IPR (12.5%; p  
ISSN:0341-2695
1432-5195
DOI:10.1007/s00264-018-4162-x