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Erschienen in:
01.10.2014 | Knee
Clinical outcomes of medial patellofemoral ligament reconstruction in patients with an increased tibial tuberosity–trochlear groove distance
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 10/2014
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Purpose
Medial patellofemoral ligament (MPFL) reconstruction is performed to treat recurrent patellar dislocation (RPD). However, the effectiveness of MPFL reconstruction in patients with a severely lateralised tibial tuberosity remains unknown. In this study, the clinical outcomes of MPFL reconstruction in patients with an increased tibial tuberosity–trochlear groove (TT–TG) distance were examined.
Methods
A total of thirty-four patients who underwent MPFL reconstruction for RPD were retrospectively examined. Nineteen patients with a TT–TG distance of >20 mm (increased TT–TG distance group) were compared with 15 patients with a TT–TG distance of <20 mm (control group). Clinical outcomes of MPFL reconstruction were evaluated by occurrence of re-dislocation, Crosby and Insall grading system, apprehension sign, and Kujala and Lysholm scores.
Results
None of the patients reported re-dislocation. Apprehension sign remained in three patients in the increased TT–TG distance group and in one patient in the control group. According to the Crosby and Insall grading system, 9 patients (47 %) were excellent, 9 (47 %) were good, and 1 (5 %) was fair to poor in the increased TT–TG distance group, while 6 (40 %) were excellent and 9 (60 %) were good in the control group. Kujala and Lysholm scores were significantly improved post-operatively in both groups. No significant correlations were observed between TT–TG distance and post-operative Kujala or Lysholm score.
Conclusion
Overall clinical outcomes of MPFL reconstruction were favourable even in patients with an increased TT–TG distance. TT–TG distance of >20 mm may not be an absolute indication for medialisation of the tibial tuberosity when performing MPFL reconstruction.
Level of evidence
Case–control study, Level III.