2015 ISAKOS Biennial Congress ePoster #1915

Patellar Osteochondral Autograft and Medial Patellofemoral Ligament Reconstruction in Patellar Dislocation

Ximena Ahumada, MD, Santiago, Region Metropolitana CHILE
David H. Figueroa, MD, Santiago, RM CHILE
Francisco Figueroa, MD, Santiago, RM CHILE
Sergio Arellano, MD, Santiago, Region Metropolitana CHILE
Guillermo Izquierdo, MD, Santiago CHILE
Rafael Calvo, MD, Santiago CHILE
Clinica Alemana de Santiago, Santiago, Region Metropolitana, CHILE

FDA Status Not Applicable

Summary: The reconstruction of the MPFL associated with an OATS procedure simultaneously in patients with acute patellar dislocation and full thickness cartilage lesion of the medial patellar facet has good functional and image outcomes at medium term follow-up, but with a low rate of sports return

Abstract:

Objective

To evaluate the functional and image outcomes and return to sports in patients with acute patellar dislocation and full thickness chondral lesion of the patella treated with simultaneously reconstruction of the medial patelofemoral ligament (MPFL) and osteochondral autograft transfer system (OATS).

Methods

Retrospective descriptive serie of 11 cases in 11 patients, all men, average age of 27 years (15-44) with clinical and imaging diagnosis of patellar acute dislocation, medial patellofemoral ligament lesion and osteochondral full thickness defect in the medial patellar facet classified according the International Cartilage Repair Society (ICRS) as grade 4. Average follow up was 18 months (6-40). All patients were treated with medial patellofemoral ligament reconstruction with autologous semitendinous graft and patellar OATS between 2011 and 2013, by the same surgical team. Functional evaluation was done with Lysholm, Kujala and subjective IKDC Scores. MRI was performed at 6 months postop and evaluated with the MOCART Scoring system. Return to sports was evaluated with Tegner Score.

Results

2 patients have had associated procedures performed simultaneously (1 trochlear microfracture, 1 distal TTA osteotomy. At 6 months, the MRI showed complete defect repair and integration in 9/11 patients. 6/11 patients returned to sports. Average preop Tegner score was 7.5 (7-8); postop Tegner score was 6.4 (5-8). Only 3 patients maintained their sport level according to the Tegner score. Average subjective IKDC score was 80.7 points (60-96). Average Lysholm score was 89.5 points (66-99). Average Kujala Score was 88 (73-94).

Conclusions

The reconstruction of the MPFL associated with an OATS procedure simultaneously in patients with acute patellar dislocation and full thickness cartilage lesion of the medial patellar facet has good functional and image outcomes at medium term follow-up, but with a low rate of sports return.