Reconstruction of the medial patellofemoral ligament in cases of acute traumatic dislocation of the patella: current perspectives and trends in Brazil

• Published in: Revista brasileira de ortopedia (English ed.) 2014-09, Vol.49 (5), p.499-506
• Main Authors: Arliani, Gustavo Gonçalves, da Silva, Adriano Vaso Rodrigues, Ueda, Léo Renato Shigueru, Astur, Diego da Costa, Yazigi Júnior, João Alberto, Cohen, Moises
• Format: Article
• Language: English
• Subjects: Articulação do joelho; Joelho; Knee; Knee joint; Ligamento patelofemoral medial; Medial patellofemoral ligament; Original; Reabilitação; Reconstruction; Reconstrução; Rehabilitation
• ISSN: 2255-4971; 2255-4971
• DOI: 10.1016/j.rboe.2014.07.005

To evaluate the approaches and procedures used by knee surgeons in Brazil for treating medial patellofemoral lesions (MPFL) of the knee in cases of acute traumatic dislocation of the patella. A questionnaire comprising 15 closed questions on topics relating to treating MPFL of the knee following acute dislocation of the patella was used. It was applied to Brazilian knee surgeons during the three days of the 44th Brazilian Congress of Orthopedics and Traumatology, in 2012. 106 knee surgeons completely filled out the questionnaire and formed part of the sample analyzed. Most of them were from the southeastern region of Brazil. The majority (57%) reported that they perform fewer than five MPFL reconstruction procedures per year. Indication of non-surgical treatment after a first episode of acute dislocation of the patella was preferred and done by 93.4% of the sample. Only 9.1% of the participants reported that they had never observed postoperative complications. Intraoperative radioscopy was used routinely by 48%. The professionals who did not use this tool to determine the point of ligament fixation in the femur did not have a statistically greater number of postoperative complications than those who used it (p>0.05). There are clear evolutionary trends in treatments and rehabilitation for acute dislocation of the patella due to MPFL, in Brazil. However, further prospective controlled studies are needed in order to evaluate the clinical and scientific benefit of these trends. Avaliar as condutas e os procedimentos feitos pelos cirurgiões de joelho do Brasil no tratamento das lesões do ligamento patelofemoral medial (LPFM) do joelho na luxação aguda traumática da patela. Questionário de 15 questões fechadas que abordava tópicos relacionados ao tratamento das lesões do LPFM do joelho após luxação aguda da patela. Foi aplicado a cirurgiões brasileiros de joelho durante os três dias do 44° Congresso Brasileiro de Ortopedia e Traumatologia, em 2012. Preencheram completamente o questionário e fizeram parte da amostra analisada 106 cirurgiões de joelho. A maior parte era proveniente da Região Sudeste. A maioria (57%) relatou fazer menos de cinco procedimentos de reconstrução do LPFM/ano. A indicação do tratamento não cirúrgico após primeiro episódio de luxação aguda da patela é a preferida e feita por 93,4% da amostra. Somente 9,1% dos participantes relataram nunca ter observado complicações no pós-operatório. A radioscopia intraoperatória é adotada rotineiramente