• Arch Orthop Trauma Surg · Aug 2024

    Long-term results after medial patellotibial ligament reconstruction for the treatment of patellofemoral instability.

    • Vittorio Davidoni, Piero Agostinone, Giacomo Dal Fabbro, Gian Andrea Lucidi, Emanuele Altovino, Alberto Grassi, and Stefano Zaffagnini.
    • Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, c/o Lab Biomeccanica ed Innovazione Tecnologica, Via Cesare Pupilli 1, Bologna, Italy.
    • Arch Orthop Trauma Surg. 2024 Aug 1; 144 (8): 341934253419-3425.

    PurposeTo evaluate long-term clinical outcomes and redislocation rate after medial patellotibial ligament reconstruction.Materials And MethodsA total of 26 knees with mean age 26.3 ± 10.6 years (25 patients, 7 males and 18 females) treated for patellar instability (at least two objective dislocations) with medialization of the patellar tendon medial third were evaluated with an intermediate clinical follow-up (FU) at a mean of 6.5 ± 2.1 years and with a final telephone interview follow-up at mean of 15.6 ± 2.5 years (11.4-20.1). Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC), Kujala, Visual Analog Scale (VAS) for pain and Tegner activity scores were used. Information about further redislocation and knee surgery was also collected.ResultsAll the clinical scores had a significant improvement compared to preoperative status (WOMAC pre-op 55.9 ± 27.2 vs. WOMAC final FU 80.8 ± 22.2; KUJALA pre-op 41.0 ± 24.0 vs. KUJALA final FU 77.2 ± 24.1; VAS pre-op 6.0 ± 3.1 vs. VAS final FU 3.44 ± 2.35; TEGNER pre-op 2.1 ± 2.0 vs. TEGNER final FU 3.6 ± 1.8; p < 0.001), and the outcomes remained stable at the final follow-up compared to the intermediate follow-up (p > 0.05). A total of 4 knees had at least one redislocation at the final follow-up, while 3 knees underwent total knee replacement surgery. The redislocation-survival rate at 5 years is 92%, meanwhile is 84% at 10 and 15 years.ConclusionsMPTL reconstruction produced good clinical results and a survival rate of 84% at a mean of 16 years follow-up and could be considered as associated procedure in case of patellofemoral instability.Level Of EvidenceLevel IV.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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