Isolated Repair of the Medial Patellofemoral Ligament in Primary Dislocation of the Patella: A Prospective Randomized Study

Christiansen, Sofus; Jakobsen, Bent Wulff; Lund, Bent; Lind, Martin

doi:10.1016/j.arthro.2008.03.012

Cited by 231 publications

(193 citation statements)

References 19 publications

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“…Buchner et al [23], in their retrospective study, separate patients who underwent diagnostic arthroscopy and refixation of the osteochondral fragment into a special group from conservatively and surgically treated patients. Sillanpaa et al [14] add those patients to a group of nonoperatively treated patients, whereas the authors of randomised studies, Nikku et al [24], Palmu et al [22], and Christiansen et al [21], regard the procedure as diagnostic and therapeutic, which is mandatory prior to final selection of operative or nonoperative treatment. In our study, diagnostic arthroscopy with simultaneous management of the essential osteochondral fragment was regarded as an operative treatment that could accompany repair of medial parapatellar structures and/or lateral retinacular release, if necessary.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, primary surgery to the medial parapatellar aspect is focused on reconstructing the MPFL and surrounding soft tissues. On the other hand, the tendency towards immediate lateral retinacular release (LRR) [20] in the aforementioned studies is controversial: from "never" [21], through "in selected cases" [10,11,22], to "always" [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Acute patellar dislocation in adolescents: operative versus nonoperative treatment

Apostolović

Vukomanović

Slavković

et al. 2011

International Orthopaedics (SICOT)

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Purpose The purpose of this prospective non-randomised study was to compare the efficacy of two opposed methods, operative and conservative. Our hypothesis was that if the method was selected correctly, on an individual basis, the results should be approximately equal. Methods The study included 37 adolescents aged between 12 and 16 years, with a mean follow up of 6.1 years. The presence of a significant loose body, confirmed by precise imaging, was the key for selecting operative or arthroscopic treatment. In both groups of patients, we evaluated functional knee scores and the incidence of residual patellofemoral disorders.Results We confirmed our hypothesis using the t-test to compare functional results and a test for comparison of proportions for incidence of residual disorders. There was no statistically significant difference (p=0.091) between operatively and conservatively treated groups with regard to functional results. The same statistical outcome emerged when comparing incidences of re-dislocation (p=0.854), or other major patellar instabilities (p=0.856), between the groups. Conclusions The results obtained should not promote a non-operative method on the basis of lower risk, but do support an individual approach based on precise diagnosis and defined criteria.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute patellar dislocation in adolescents: operative versus nonoperative treatment

Apostolović

Vukomanović

Slavković

et al. 2011

International Orthopaedics (SICOT)

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“…Surgical treatment is indicated in cases of recurrent patellar dislocations or in primary patellar dislocations associated with large (>5 mm) displaced osteochondral fractures or chondral shear fragments, and/or complete avulsion of the vastus medialis oblique from the patellar insertion site [10,[20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Medial Patellofemoral Ligament Reconstruction in Adolescents Affected by Patellar Instability

Testa

Pavone

Lucenti

et al. 2017

JFMK

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Patellar instability is a heterogeneous group of morphological and functional disorders of the knee extensor mechanism. The medial patellofemoral ligament (MPFL) has been recognized as being important in stabilizing the patella and preventing lateral patellar dislocation. Recurrent dislocations in the pediatric population may benefit from surgical intervention. The aim of this study is to retrospectively evaluate adolescent patients treated with surgical reconstruction of medial patello-femoral ligament. Between January 2009 and December 2014, seven patients with patellar instability were treated at the Department of Orthopaedics and Traumatology of the University of Catania, Sicily. Five patients (71.4%) were female and two (28.6%) were male. The mean age at the time of surgery was 14.9 ± 1.1 years (range 13-16 years). All cases were treated with reconstruction of the MPFL. Clinical outcomes and complications were reported. Mean follow-up was 26.1 ± 10.9 months (range 12-46 months). Evaluation at two years after surgery identified an average Knee Society Score (KSS) of 94.3 ± 7.4 (range 78-100). An excellent result was obtained in six patients (85.7%) and a good result was obtained in one patient (14.3%). A recurrence was reported in one patient (14.3%). This study shows that surgical treatment of patellar instability by reconstruction of MPFL leads to satisfying results at mid-term follow-up.

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“…However, studies investigating MPFL repair have had less favourable outcomes than other procedures. In a prospective randomised trial comparing patients treated with immobilisation to MPFL repair, Christiansen et al found no significant differences in re-dislocation rates, knee function, or pain after a primary dislocation 39 . Among patients with recurrent patellar instability, Camp et al reported a 28% re-dislocation rate in patients after a medial repair 40 .…”

Section: Medial Repairmentioning

confidence: 99%

Patellar instability

Goodwin¹,

Postma²

2013

OA Sports Medicine

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Isolated Repair of the Medial Patellofemoral Ligament in Primary Dislocation of the Patella: A Prospective Randomized Study

Cited by 231 publications

References 19 publications

Acute patellar dislocation in adolescents: operative versus nonoperative treatment

Acute patellar dislocation in adolescents: operative versus nonoperative treatment

Medial Patellofemoral Ligament Reconstruction in Adolescents Affected by Patellar Instability

Patellar instability

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