Recurrent Patellar Dislocation
Conditions
Keywords
Patellar Instability, Medial Patellofemoral Ligament, MPFL Reconstruction, Hamstring Tendon Graft, Quadriceps Tendon Graft
Brief summary
This prospective comparative study compared the clinical and radiological outcomes of medial patellofemoral ligament (MPFL) reconstruction using a hamstring tendon graft versus a quadriceps tendon graft in patients with recurrent patellar dislocation. The study included 38 patients with 40 affected knees who underwent MPFL reconstruction using either a hamstring tendon graft or a quadriceps tendon graft, according to the treating surgeon's preference. Patients were prospectively followed in two groups according to the graft used. Clinical outcomes were assessed using the Kujala, International Knee Documentation Committee (IKDC), and Tegner-Lysholm scores. Radiological assessment included patellar tilt angle and congruence angle. Postoperative complications and recurrent patellar instability were also evaluated.
Interventions
PROCEDUREMPFL Reconstruction Using Hamstring Tendon Graft
Medial patellofemoral ligament reconstruction was performed using an autologous semitendinosus tendon graft. The graft was fixed to the medial aspect of the patella and passed between layers 2 and 3 of the medial knee structures, followed by femoral fixation at the anatomical MPFL insertion.
PROCEDUREMPFL Reconstruction Using Quadriceps Tendon Graft
Medial patellofemoral ligament reconstruction was performed using a distally based superficial quadriceps tendon graft. The graft remained attached to the superior pole of the patella, was passed between layers 2 and 3 of the medial knee structures, and was fixed at the anatomical femoral insertion of the MPFL.
Sponsors
Cairo University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Patients with recurrent patellar dislocation. * Age from 18 to 40 years. * Patients indicated for isolated medial patellofemoral ligament (MPFL) reconstruction.
Exclusion criteria
1. Patients with trochlear dysplasia (Dejour B-C-D). 2. Patients with clinical evidence of mal-alignment (varus, valgus, flat foot and femoral anteversion). 3. Patients with congenital pateller dislocation. 4. Patella alta and patella baja. 5. Previous quadriceps muscles operation. 6. Patients with patellofemoral OA. 7. Patients with hypermobility syndrome. 8. Patients with associated pathology.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Kujala score | 12 months postoperatively | Functional outcome assessed using the Kujala anterior knee pain scale. The score ranges from 0 to 100, with higher scores indicating better knee function and fewer patellofemoral symptoms. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| International Knee Documentation Committee (IKDC) Score | 12 months postoperatively | Knee function was assessed using the International Knee Documentation Committee (IKDC) score. Scores range from 0 to 100, with higher scores indicating better knee function. |
| Tegner-Lysholm Knee Score | 12 months postoperatively | Knee function was assessed using the Tegner-Lysholm knee score. Scores range from 0 to 100, with higher scores indicating better knee function. |
| Patellar Tilt Angle | 12 months postoperatively | Patellar tilt angle was measured radiologically to assess patellofemoral alignment before and after MPFL reconstruction. |
| Congruence Angle | 12 months postoperatively | Congruence angle was measured radiologically to assess patellofemoral alignment before and after MPFL reconstruction. |
| Incidence of Re-dislocation | 12 months postoperatively | Number of cases who experienced re-dislocation after MPFL reconstruction |
Countries
Egypt
Outcome results
None listed