VIDEO: Not all patients with patellar dislocation need more than MPFL reconstruction
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Key takeaways:
- It is unclear if an isolated medial patellofemoral ligament reconstruction would benefit 60% to 70% of patients with patellar dislocation.
- Researchers plan to create a patellar instability severity index score.
NEW ORLEANS — In this video, Beth E. Shubin Stein, MD, discusses when surgeons should perform more than a medial patellofemoral ligament reconstruction in patients with patellar dislocation.
“The question is not: Is an MPFL enough? An MPFL is mandatory in somebody who had recurrent instability,” Shubin Stein, an orthopedic surgeon at Hospital for Special Surgery, told Healio. “The question is: When do we need to add something else in order to stabilize them and are they at higher risk for redislocation if we just do an MPFL? And the answer is, we don’t know who that group is.”
While there are groups of patients who can do well with either an isolated MPFL reconstruction or an MPFL reconstruction in conjunction with another procedure, Shubin Stein said in 60% to 70% of patients the answer of whether to do an isolated or combined procedure MPFL is unclear. To better identify the correct treatment for these patients, Shubin Stein said she and her colleagues are conducting a study to create a patellar instability severity index score to identify each patient’s risk factor for doing well or poorly with an isolated MPFL reconstruction.
“If we know that they’re bound to do poorly and have either a significant recurrence risk or low patient-reported outcomes, which is another side of the study that we’re looking at, then we can indicate those patients at the outset for more than just an MPFL [reconstruction],” Shubin Stein said.
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Shubin Stein BE. The MPFL is enough! Leave the hardware alone. Presented at: Arthroscopy Association of North America Annual Meeting; May 4-6, 2023; New Orleans.
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