The Results of Recurrent Patellar Dislocation Treatment With MPFL Reconstruction in Adolescents With a Minimum Three-year Follow-up: A Prospective Study

Abstract

PurposeThe aim of this prospective study is to perform a clinical and radiological assessment of the results of surgical treatment in a homogenous group of adolescents with recurrent patellar dislocation (RPD), using medial patellofemoral ligament (MPFL) reconstruction as the basic technique. MethodsTwenty-two patients reported to the follow-up examination after at least three years, including four patients who underwent bilateral surgery (26 knees). The mean age at the time of the surgery was 15.4 years. The subjects were asked to complete the Lysholm-Tegner Knee Scale and the Kujala Anterior Knee Pain Scale before surgery and after follow-up. Based on the imaging results, the Caton-Deschamps Index (CDI), congruence angle (CA), patellofemoral angle (PFA) and Wiberg classification of the patella shape were assessed. ResultsTwo incidents of patellar redislocation was noted. Both the Lysholm-Tegner and Kujala Scale scores significantly improved after follow-up (p<0.001). CDI did not change significantly (p=0.681). The values of both PFA and CA significantly decreased after surgery (p<0.001). An incorrect congruence angle (patellar shift) was present in 22 knees pre-op and ten post-op (p=0.002). Increased patellofemoral angle (patellar tilt) was present in 21 knees pre-op and seven post-op (p<0.001). A statistically significant correlation was demonstrated between PFA and both Lyscholm-Tegner and Kujala score (in both p<0.001, r=-0.5). A slight, but significant, correlation was found between CA and Kujala score (p=0.008, r= -0.036). ConclusionSurgical treatment causes a considerable improvement in the functional assessment of patients, as well as anatomical conditions within the patellofemoral joint.ClinicalTrials.gov record No PMMHRI-BCO.34/2019ClinicalTrials.gov Identifier: NCT03983213https://clinicaltrials.gov/ct2/show/NCT03983213Registered 06/12/2019 - Retrospectively registered