Medial Patellofemoral Ligament Reconstruction in Adolescents Affected by Patellar Instability

Abstract

Patellar instability is a heterogeneous group of morphological and functional disorders of the knee extensor mechanism. The medial patellofemoral ligament (MPFL) has been recognized as being important in stabilizing the patella and preventing lateral patellar dislocation. Recurrent dislocations in the pediatric population may benefit from surgical intervention. The aim of this study is to retrospectively evaluate adolescent patients treated with surgical reconstruction of medial patello-femoral ligament. Between January 2009 and December 2014, seven patients with patellar instability were treated at the Department of Orthopaedics and Traumatology of the University of Catania, Sicily. Five patients (71.4%) were female and two (28.6%) were male. The mean age at the time of surgery was 14.9 ± 1.1 years (range 13-16 years). All cases were treated with reconstruction of the MPFL. Clinical outcomes and complications were reported. Mean follow-up was 26.1 ± 10.9 months (range 12-46 months). Evaluation at two years after surgery identified an average Knee Society Score (KSS) of 94.3 ± 7.4 (range 78-100). An excellent result was obtained in six patients (85.7%) and a good result was obtained in one patient (14.3%). A recurrence was reported in one patient (14.3%). This study shows that surgical treatment of patellar instability by reconstruction of MPFL leads to satisfying results at mid-term follow-up.

The “Journal of Functional Morphology and Kinesiology” Journal Club Series: Highlights of Recent Papers in Pediatric Exercise

“…Highlight by Vito Pavone, Andrea Vescio, Gianluca Testa Patellar dislocation is a common knee injury in the pediatric population, generally caused by a deficiency or a complete lesion of the medial patellofemoral ligament (MPFL). MPFL insufficiency causes a limitation of the patellofemoral joint, promoting cartilage tear and degeneration, with consequent early osteoarthrosis in young adulthood [6].…”

The Joystick Method: A Mini Open Technique for Repairing Patellar Osteochondral Fractures With Concomitant Medial Patellofemoral Ligament Reconstruction

“… 3 , 4 In contrast, the recurrence rate drops to 10% to 20% with MPFL reconstruction. 3 , 5 Typically, a large medial or lateral parapatellar arthrotomy is required to evert the patella to expose its articular surface for OCF fixation. 6 , 7 Cases involving medial patellar facet OCFs can be fixed using a mini-medial parapatellar arthrotomy since the patella does not need to be fully exposed.…”