ISAKOS Congress 2021

2021 ISAKOS Biennial Congress Paper

 

Evaluation Of Medial Patellofemoral Ligament Reconstruction In Inmature Skeleton. A Comparative Study Between Two Techniques

Juan Miguel Del Castillo, MD, Montevideo, Montevideo URUGUAY
Martín Sierra, MD, Montevideo URUGUAY
Juan Dupont URUGUAY
Johan von Heideken, MD, PhD, Stockholm, Stockholm SWEDEN
Juan Enrique Kenny Pujadas, MD, Montevideo, Montevideo URUGUAY

CENTRO HOSPITALARIO PEREIRA ROSSELL, MONTEVIDEO, URUGUAY

FDA Status Not Applicable

Summary

Our study evaluates the functional results of two groups of patients treated by two different techniques of LPFM reconstruction, one anatomic with autologous semitendinosus and the other non-anatomic with autologous quadrcipital hemitendon

Abstract

Patellofemoral dislocation accounts for 3% of traumatic knee injuries, with two-thirds occurring in patients under 20 years of age. Recurrence after the second episode is greater than 50%, which can cause great functional limitation in young patients, reducing their quality of life. The immature skeleton implies a therapeutic problem since the remaining growth potential must be preserved. Medial patellofemoral ligament (MPFL) is the main medial stabilizer of the patella at 30° flexion, currently its anatomic reconstruction preserving the physis appears to be the best option in these cases until they are candidates for other corrective surgeries.

Our study evaluates the functional results of two groups of patients treated by two different techniques of MPFL reconstruction, one anatomic with autologous Semitendinosus (ST) and the other non-anatomic with autologous quadricipital hemi tendon (QT). Both groups were evaluated through the Kujala score before surgery and during follow-up. Means and score items were compared using Wilcoxon signed-rank test.

Twenty-two knees were evaluated, eleven in each group. Patient’s age ranged between 8 and 15 years old. The mean follow-up was 19.4 months (range 7-30). Results show an improvement in the average Kujala scores for the ST group from 51 to 88 and in the QT group from 52 to 97. Kujala score was statistically significantly higher in the postoperative evaluation with both technics (p-value 0.003 for both groups) while we did not find any statistical difference between both techniques in Kujala score at follow up. Only one case of patella redislocation from the QT group was registered during the study period.

In conclusion, we can affirm that MPFL reconstruction is a valid therapeutic option for patellofemoral dislocation and the proposed techniques are reliable choices in patients with immature skeleton.

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