MPFL reconstruction for lateral instability yielded improved static bipedal balance
Key takeaways:
- MPFL reconstruction yielded improved static bipedal balance control at 374 days postoperatively.
- Postural sway was comparable between patients who underwent MPFL reconstruction and healthy controls.
Patients with lateral patellar instability had improved static bipedal balance control at 1 year after medial patellofemoral ligament reconstruction, according to published results.
Researchers analyzed balance control, postural stability and clinical outcomes of 26 patients with recurrent lateral patellar instability who underwent isolated MPFL reconstruction and 26 matched, healthy control patients.
According to the study, researchers used a vertical force platform to measure preoperative and postoperative double-leg static posturographic tests. Patients performed the tests with their eyes open and then closed, as well as with or without a foam support. Clinical outcomes included the IKDC subjective knee form, Lysholm knee scoring scale, Tampa scale for kinesiophobia and active range of motion.
At 11 days preoperatively, researchers found significant differences in overall observed postural sway between the groups, as patients in the experimental group had a postural sway of 268.4 mm2 and control patients had a postural sway of 229.2 mm2. However, at 374 days postoperatively, patients in the experimental group had a postural sway of 252.6 mm2 and control patients had a postural sway of 234.6 mm2. Researchers noted these differences were not statistically significant.
“Static bipedal balance control can be improved under surface perturbation in these patients 1 year after isolated MPFL reconstruction that enhances the possibility of normal restoration of postural stability,” the researchers wrote in the study. “Structural recovery of the ligament could help restore the sensorimotor efficiency and generate the compensatory and anticipatory balance regulation strategies, thereby improving joint function,” they concluded.
Perspective
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Fenghua Tao and colleagues performed an interesting study looking at balance control in patients with patellar instability before and after MPFL reconstruction. They compared this group to a healthy, matched control cohort. It is nice to have objective evidence that patients with patellar instability have deficits beyond patellar apprehension. It makes sense that balance is not normal in the setting of an unstable patella. Balance control was improved after MPFL reconstruction with appropriate rehabilitation, highlighting the importance of good therapy in the postoperative setting to maximize outcomes after MPFL reconstruction.
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