Patients who undergo tibial tubercle anteromedialization with medial patellofemoral ligament reconstruction demonstrate similar rates of return to sport compared to isolated MPFL reconstruction

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2024-02, Vol.32 (2), p.371-380
• Main Authors: Li, Zachary I., Garra, Sharif, Eskenazi, Jordan, Montgomery, Samuel R., Triana, Jairo, Hughes, Andrew J., Alaia, Michael J., Strauss, Eric J., Jazrawi, Laith M., Campbell, Kirk A.
• Format: Article
• Language: English
• Subjects: MPFL; psychological readiness; return to sport; return to work; tibial tubercle osteotomy
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1002/ksa.12051

Purpose To investigate the rate of return to sports and sport psychological readiness between patients who underwent isolated MPFLR (iMPFLR) compared to a matched cohort of patients who underwent MPFLR with anteromedializing tibial tubercle osteotomy (MPFLR/TTO). Methods Patients who underwent primary MPFLR with or without TTO for recurrent patellar instability were retrospectively reviewed from 2012 to 2020 at a single institution. Preinjury sport and work information, Kujala, Tegner, Visual Analogue Score for pain, satisfaction and MPFL‐Return to Sport after Injury (MPFL‐RSI) score were collected. Two readers independently measured the tibial tuberosity‐trochlear groove distance, Caton–Deschamps index and Dejour classification for trochlear dysplasia. Patients in iMPFLR and MPFLR/TTO groups were matched 1:1 on age, sex, body mass index and follow‐up length. Multivariate regression analysis was performed to determine whether the MPFL‐RSI was associated with a return to sport. Results This study included 74 patients at mean follow‐up of 52.5 months (range: 24–117). These groups returned to sport at similar rates (iMPFLR: 67.6%, MPFLR/TTO: 73.0%, not significant [ns]), though iMPFLR patients returned more quickly (8.4 vs. 12.8 months, p = 0.019). Rates of return to preinjury sport level were also similar (45.9% vs. 40.5%, ns). Patients with Dejour B/C took more time to return to sport compared to patients with mild/no trochlear pathology (13.8 vs. 7.9 months, p = 0.003). Increasing MPFL‐RSI score was significantly predictive of the overall return to sport (odds ratio [OR]: 1.08, 95% confidence interval [CI] [1.03, 1.13], p