Medial Patellofemoral Ligament Reconstruction Using Allografts in Skeletally Immature Patients

Background: Patellar instability has the highest incidence in adolescents aged between 14 and 18 years. The unique relationship between the medial patellofemoral ligament (MPFL) and the distal femoral physis in skeletally immature patients warrants precisely positioned MPFL graft insertion. A paucit...

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Bibliographic Details
Published in:The American journal of sports medicine 2023-05, Vol.51 (6), p.1513-1524
Main Authors: Husen, Martin, Milbrandt, Todd A., Shah, Veeraj, Krych, Aaron J., Stuart, Michael J., Saris, Daniel B.F.
Format: Article
Language:English
Subjects:
Adolescent
Allografts
Child
Clinical outcomes
Failure
Humans
Injuries
Joint Dislocations
Joint Instability - etiology
Joint Instability - surgery
Knee Injuries - complications
Ligaments, Articular - surgery
Patellar Dislocation - surgery
Patellofemoral Joint - surgery
Patients
Retrospective Studies
Sports medicine
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Summary:Background: Patellar instability has the highest incidence in adolescents aged between 14 and 18 years. The unique relationship between the medial patellofemoral ligament (MPFL) and the distal femoral physis in skeletally immature patients warrants precisely positioned MPFL graft insertion. A paucity of data are available evaluating the results of MPFL reconstruction using allograft tendon before skeletal maturity. Purposes: (1) To assess the results of MPFL reconstruction using allograft tendon in skeletally immature patients by analyzing redislocation and reoperation rates, radiological outcomes, and patient-reported outcomes and (2) to determine whether epidemiological, intraoperative, or radiographic factors influence recurrent instability and clinical outcomes. Study Design: Case series; Level of evidence, 4. Methods: Prospectively collected data were retrospectively analyzed for 69 skeletally immature patients who experienced a first-time or recurrent lateral patellar dislocation and were treated with anatomic MPFL reconstruction. Inclusion criteria were MPFL reconstruction using allograft and the availability of preoperative magnetic resonance imaging scans in the presence of open or partially open physes. Patients with
ISSN:0363-5465
1552-3365
DOI:10.1177/03635465231164400