2023 ISAKOS Biennial Congress ePoster
Patients who Undergo Bilateral Medial Patellofemoral Ligament Reconstruction Return to Sport at a Similar Rate as Those that Undergo Unilateral Reconstruction: A Matched Cohort Study
Zachary I Li, BA, New York UNITED STATES
Jairo Triana, BS, New York, NY UNITED STATES
Ariana Lott, MD, Princeton, NJ UNITED STATES
Naina Rao, BS UNITED STATES
Taylor Jazrawi, Masters, New York, New York UNITED STATES
Samuel Montgomery, MD, New York, New York UNITED STATES
Michael Buldo-Licciardi, BS, New York UNITED STATES
Michael J Alaia, MD, New York, New York UNITED STATES
Eric Jason Strauss, MD
Kirk Anthony Campbell, MD, New York, NY UNITED STATES
NYU Langone Health, New York, NY, UNITED STATES
FDA Status Not Applicable
Summary
The purpose of this study is to compare patients who have received bilateral MPFLR to a matched unilateral cohort, to elucidate potential differences and eventually allow better prognostication of this unique population’s ability to return to sports.
ePosters will be available shortly before Congress
Abstract
Purpose
Lateral patellar instability is a debilitating condition not only to athletes, but also a broad range of highly active individuals. Many of these patients experience symptoms bilaterally, though it is unknown how these patients fair with return to sports following a second medial patellofemoral ligament reconstruction (MPFLR). The purpose of this study is to evaluate the rate of return to sport following bilateral MPFLR compared to a matched unilateral cohort.
Methods
Patients who underwent primary MPFLR with minimum 2-year follow-up were identified from 2014 to 2020 at an academic center. Those who underwent primary MPFLR of bilateral knees were identified. Pre-injury sport participation and Tegner score, Kujala score, Visual Analog Score (VAS) for pain, satisfaction, and MPFL-Return to Sport after Injury (MPFL-RSI) score were collected. Bilateral and unilateral MPFLRs were matched in a 1:2 ratio based on age, sex, BMI, and concomitant tibial tubercle osteotomy (TTO). A sub-analysis was performed regarding concomitant TTO.
Results
The final cohort consisted of 63 patients, including 21 patients who underwent bilateral MPFLR, matched to 42 unilateral patients at mean follow-up of 47 ± 27 months. Patients who underwent bilateral MPFLR returned to sport at a rate of 62% at a mean of 6.0 ± 2.3 months, compared to a unilateral rate of 72% at 8.1 ± 4.2 months. Rate of return to pre-injury level was 43% among bilateral patients and 38% in the unilateral cohort. There were no significant differences in Kujala (p=0.06), current Tegner (p=0.24), satisfaction (p=0.95), pain (p=0.52), and MPFL-RSI (p=0.22) scores between cohorts. Approximately half of those (47%) who failed to return to sport cited psychological factors and had significantly lower MPFL-RSI scores (74.2 vs 36.6, p=0.001). Males returned to pre-injury sport level at a greater rate (60%) compared to females (18%), p<0.001.
Conclusion
Patients who undergo MPFLR bilaterally returned to sports at a similar rate and level compared to a matched unilateral comparison group. Kujala, current Tegner, and MPFL-RSI scores were lower, though not significantly, in the bilateral group. MPFL-RSI was found to be significantly associated with return to sport.