Satisfactory midterm clinical results and low incidence of patellofemoral arthritis after MPFL reconstruction for patellar instability, in patients with low-grade trochlear dysplasia

IF 5.5 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2026-09-29 Epub Date: 2025-10-22 DOI:10.1002/ksa.70101

Theodoros Mylonas, Vasileios Raoulis, Efstathios Konstantinou, Alexandros Koskiniotis, Georgios Komnos, Michael Hantes

{"title":"Satisfactory midterm clinical results and low incidence of patellofemoral arthritis after MPFL reconstruction for patellar instability, in patients with low-grade trochlear dysplasia","authors":"Theodoros Mylonas, Vasileios Raoulis, Efstathios Konstantinou, Alexandros Koskiniotis, Georgios Komnos, Michael Hantes","doi":"10.1002/ksa.70101","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>Patella dislocation is among the most common knee pathologies in the young population. The anatomical structure getting injured in these cases is the medial patellofemoral ligament (MPFL), leading to patella instability. This study aims to evaluate the medium to long-term clinical results of our double-bundle technique for isolated MPFL reconstruction with hamstring autograft, mainly focusing on the incidence of subsequent patellofemoral arthritis.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A retrospective analysis of 35 patients (39 patellae) with patella instability treated with isolated MPFL reconstruction surgery by the same orthopaedic surgeon between 2010 and 2020 was conducted. Patients were assessed using the following patient reported outcome measures: International Knee Documentation Committee (IKDC), Lysholm, Kujala and Modified Cincinnati, both pre and postoperatively. Additionally, the development of posttraumatic patellofemoral arthritis based on the Iwano classification was assessed by evaluating X-rays performed before surgery and at the final follow-up.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The mean patients' age at the time of the first dislocation was 16.1 years (range, 10–21 years), and the mean age at the time of surgery was 20.3 years (range, 18–26). Females were 56,2% of the patients, and 43.8% were males; 75% of the injuries occurred during sport activities, while the rest after a direct hit. The mean follow-up was 7.3 years (5–13). All scores demonstrated significant melioration postoperatively. At the final follow-up, the IKDC score increased from 49.2 to 84.5, Lysholm from 53 to 88.2, Kujala from 61 to 88.5, and modified Cincinnati from 49.2 to 83.6. No immediate postoperative complication was reported, and no redislocation was recorded. Radiological evaluation indicated only mild signs of patellofemoral arthritis in eight patients (20%).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The double-bundle technique for MPFL reconstruction with hamstring autograft is a safe and reliable option for treating patella dislocation in patients with low-grade trochlear dysplasia. It provides satisfactory outcomes without remarkable arthritic changes at a mid term follow-up.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level III.</p>\n </section>\n </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"34 10","pages":"3520-3529"},"PeriodicalIF":5.5000,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ksa.70101","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/10/22 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Patella dislocation is among the most common knee pathologies in the young population. The anatomical structure getting injured in these cases is the medial patellofemoral ligament (MPFL), leading to patella instability. This study aims to evaluate the medium to long-term clinical results of our double-bundle technique for isolated MPFL reconstruction with hamstring autograft, mainly focusing on the incidence of subsequent patellofemoral arthritis.

Methods

A retrospective analysis of 35 patients (39 patellae) with patella instability treated with isolated MPFL reconstruction surgery by the same orthopaedic surgeon between 2010 and 2020 was conducted. Patients were assessed using the following patient reported outcome measures: International Knee Documentation Committee (IKDC), Lysholm, Kujala and Modified Cincinnati, both pre and postoperatively. Additionally, the development of posttraumatic patellofemoral arthritis based on the Iwano classification was assessed by evaluating X-rays performed before surgery and at the final follow-up.

Results

The mean patients' age at the time of the first dislocation was 16.1 years (range, 10–21 years), and the mean age at the time of surgery was 20.3 years (range, 18–26). Females were 56,2% of the patients, and 43.8% were males; 75% of the injuries occurred during sport activities, while the rest after a direct hit. The mean follow-up was 7.3 years (5–13). All scores demonstrated significant melioration postoperatively. At the final follow-up, the IKDC score increased from 49.2 to 84.5, Lysholm from 53 to 88.2, Kujala from 61 to 88.5, and modified Cincinnati from 49.2 to 83.6. No immediate postoperative complication was reported, and no redislocation was recorded. Radiological evaluation indicated only mild signs of patellofemoral arthritis in eight patients (20%).

Conclusions

The double-bundle technique for MPFL reconstruction with hamstring autograft is a safe and reliable option for treating patella dislocation in patients with low-grade trochlear dysplasia. It provides satisfactory outcomes without remarkable arthritic changes at a mid term follow-up.

Level of Evidence

Level III.

查看原文本刊更多论文

在轻度滑车发育不良患者中，因髌骨不稳而行MPFL重建后的中期临床结果令人满意，髌股关节炎发病率低。

目的：髌骨脱位是年轻人群中最常见的膝关节病变之一。在这些病例中受伤的解剖结构是髌股内侧韧带（MPFL），导致髌骨不稳定。本研究旨在评估我们的双束技术与自体腘绳肌腱移植重建离体强韧带的中长期临床结果，主要关注随后髌骨股关节炎的发生率。方法：回顾性分析2010年至2020年同一骨科医师对35例髌骨不稳患者（39个髌骨）行分离性外胫腓韧带重建手术。术前和术后使用以下PROMs对患者进行评估：IKDC、Lysholm、Kujala和Modified Cincinnati。此外，根据Iwano分类，通过评估术前和最后随访时的x射线来评估创伤后髌骨关节炎的发展。结果：患者首次脱位时的平均年龄为16.1岁（范围10 ~ 21岁），手术时的平均年龄为20.3岁（范围18 ~ 26岁）。女性56.2%，男性43.8%；75%的受伤发生在体育活动中，而其余的则是在直接撞击之后。平均随访7.3年（5 ~ 13岁）。所有评分均显示术后明显改善。在最后的随访中，IKDC得分从49.2上升到84.5，Lysholm从53上升到88.2，Kujala从61上升到88.5，辛辛那提从49.2上升到83.6。无术后即刻并发症报道，无再脱位记录。放射学评估显示8例（20%）患者仅有轻度髌骨关节炎症状。结论：自体腘绳肌腱双束技术是治疗低级别滑车发育不良患者髌骨脱位的一种安全可靠的选择。在中期随访中，它提供了令人满意的结果，没有明显的关节炎变化。证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).