Summary

MPFL reconstruction after first-time patellofemoral dislocation does not demonstrate a difference in failure rate, patient reported outcomes or complication rate, as compared to MPFLr performed on children and adolescents with recurrent dislocations.

Abstract

Purpose

MPFL reconstruction is the treatment of choice for recurrent instability. After a first-time dislocation, MPFLr is indicated only in patients with a high risk of recurrence or major osteochondral injury. This study aims to compare outcomes of MPFL reconstruction after first-time dislocation versus recurrent instability in the pediatric population.

Methods

This retrospective cohort study included pediatric and adolescent patients who underwent MPFL reconstruction. Demographic data, risk factors for patellofemoral instability, and injury mechanism were collected. The primary outcome was failure, defined as subsequent dislocation. Secondary outcomes included patient reported outcome measures (IKDC, KOOS, Lysholm scores), return to sport at pre-injury levels (RTS), and complications.

Results

Forty-eight patients were included in the analysis, with a median follow-up of 34.9±11.9 months. There were no significant differences in demographic variables between the two groups. We did not find a significant difference in failure rate (p=0.73). Excellent patient reported outcomes were reported in both groups. No statistically significant difference in IKDC, KOOS and Lysholm scores (98±3.3 vs. 96±7.3, p=0.79; 97±4.5 vs. 94±9.8, p=0.16; 99±2.0 vs. 99±8.0, p=0.47, respectively) were found between the two groups. Complication rates were also not significantly different between recurrent dislocation MPFLr compared to the first-time dislocation patients (12.5% versus 0%, p=0.15).

Conclusion

MPFL reconstruction after first-time patellofemoral dislocation did not demonstrate a difference in failure rate, patient reported outcomes, or complication rate, as compared to MPFLr performed on children and adolescents with recurrent dislocations.