Reconstruction of the medial patellofemoral ligament is effective in treating lateral patellofemoral instability, even in the presence of trochlear dysplasia. A review of 18 cases

Abstract

71 ABSTRACT Objectives: To assess the need for trochleoplasty in the presence of trochlear dysplasia (TD) in cases of patellofemoral instability (PFI), and review the surgical and functional outcomes in our series of patients. Material and methods: A retrospective study was made of 18 patients subjected to reconstruction of the medial patellofemoral ligament (MPFL) with a tendon allograft affixed by two anchorings in the patella and transosseous femoral tunnel. Anteromedialisation osteotomy of the extensor apparatus was added in 8 patients. The study parameters were the presence of TD (according to the Dejour classification), the distance between the anterior tibial tuberosity and the trochlear groove (TT-TG), the postoperative functional outcome according to the Kajula scale, and the cases of patellofemoral dissociation relapse. The postoperative functional outcomes and relapses were analysed according to the grade of associated TD. Results: The mean patient age was 24.5 ± 7.6 years at the time of surgery, and 66% of the patients were women. The mean postoperative follow-up was 6.5 years (range: 1-12 years). Some grade of TD was recorded in 77.8% of the patients: four cases of Dejour type A trochlea, three cases of type B, two cases of type C and 5 cases of type D. An anteromedialisation tibial osteotomy was added in the cases with increased AT-TG (33.3%). One instability relapse was recorded in the postoperative period. There were no differences in the postoperative functional outcomes between the groups with or without TD (p > 0.05). There likewise were no differences in the case of the relapses. RESUMEN La reconstrucción del ligamento patelofemoral medial es eficaz en el tratamiento de la inestabilidad patelofemoral lateral, incluso en presencia de displasia troclear. Una revisión de 18 casos