MPFL reconstruction may be safe, effective for dislocation, instability in young patients
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Medial patellofemoral ligament reconstruction may be a safe and effective treatment option for adolescent patients with patellar dislocations and instability, according to published results.
In a systematic review of the current literature on MPFL reconstruction, researchers analyzed data from 12 studies on a total of 352 knees (332 patients, mean age of 14.28 years) who underwent MPFL reconstruction for patellar instability. According to the study, the researchers used PubMed, Scopus, EMBASE and the Cochrane databases to select articles.
At a mean follow-up of 30.17 months, 18 recurrences of patellar instability (5.1%) were recorded. Additionally, researchers found a 4.5% complication rate (n = 16). Complications included one patella fracture, one screw removal due, one infection, two instances of postoperative stiffness, five wound complications and six subluxations, according to the study.
“Chronic patellar instability episodes may lead to further cartilage injury and debilitating pain, limit daily living activities and stall one’s return to sports,” the researchers wrote in the study. “MPFL reconstruction in young patients can be considered as an effective and safe treatment leading to clinical improvement. No major complications related to the technique were reported, but a high level of research evidence is required to better evaluate the clinical results in a long-term follow-up,” they concluded.
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Based on a systematic review of 12 published studies, the authors report that MPFL reconstruction is safe and effective for management of patellar instability in patients younger than 20 years of age. Gracilis autograft was used in more than half of the 352 knees that were included in the study. The outcomes were acceptable and complication rate was low, irrespective of graft type or fixation method.
The most common complications were recurrent instability (5.1%), subluxation (1.7%), wound-related complications (1.4%) and knee stiffness (0.6%). The study lacked analysis or discussion related to the cause, management or prevention of these complications. There were no reported cases of growth disturbances in skeletally immature patients, though the follow-up period in some studies was as short as 3 months. The level of evidence in 10 of the 12 studies was level III or beyond; this review identifies the need for higher level of research evidence.
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