Study finds low failure rate following MPFL repair for recurrent patellar instability
According to a study in Orthopedics, patellar-sided medial patellofemoral ligament repair had a failure rate of less than 10% in patients with chronic, recurrent patellar instability and a low tibial tubercle-trochlear groove distance.
Aaron P. Beck, MD, and colleagues from the department of orthopedics and rehabilitation at the University of Wisconsin analyzed 41 isolated, patellar-sided medial patellofemoral ligament (MPFL) repairs in 38 patients with chronic, recurrent patellar instability (RPI) in the setting of low tibial tubercle-trochlear groove (TT-TG) distance. Outcomes were measured at a median follow-up of 32 months and included postoperative magnetic resonance imaging, Kujala score, patellar dislocation and revision, according to the study.
Overall, four patients (9.8%) had an outcome that was considered a failure; 14 patients (34.1%) had a fair outcome; and 23 patients (56.1%) had an excellent outcome. Increased patellar height, as determined by the Caton-Deschamps Index (CDI), was the only variable associated with an increased risk of failure. Mean CDI was 1.23 mm in the four failures compared with 1.08 mm in the nonfailures.
“These results - superior to most that have been published for this procedure and indication, and in line with the small series of Dragoo, et al and Bryant and Pandya - were likely related to patient selection and surgical technique,” Beck and colleagues wrote in the study. “Elevated patellar height appears to be a risk factor for recurrence and should be carefully considered when identifying patients for surgical treatment,” they added.
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