Abstract
Purpose
The suture anchor technique for medial capsular plication has been previously described. We present our technique and its medium-term results.
Methods
A single surgeon’s experience (senior author) of the suture anchor technique for medial capsular plication was reviewed in 14 knees in 14 patients. All patients underwent arthroscopic stabilisation for patello-femoral instability. The method used was the suture anchor technique for medial capsular plication (full technique described in paper). The primary outcome measure used was further dislocation or instability. The validated Kujala score was used pre- and post-op to assess functional outcome.
Results
There were nine male and five female patients (M:F, 64 %:34 %). Median age was 25 (range 16–65). Mean follow-up was 52 months (95 % CI 44–56 range 24–72). The mean pre-op Kujala score was 54.6 (SD 24.4). The mean post-op Kujala score was 78.2 (SD 20.5). The mean increase in Kujala score was 23.6 (95 % CI 7.9–39.4). There was a statistically significant increase in Kujala score, P = 0.006. Only 1 of 14 patients had a further dislocation (7 %), and there were no further episodes of instability.
Conclusion
This is the first paper to describe the results of this technique in the literature. There was a statistically significant improvement in the patients’ functional outcome and 13/14 patients did not re-dislocate or experience instability. It was concluded that this technique is a successful mode of treatment for patello-femoral instability.
Level of evidence
Case series, Level IV.
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References
Ahmad CS, Lee FY (2001) An all-arthroscopic soft-tissue balancing technique for lateral patellar instability. Arthroscopy 17(5):555–557
Andrish J (2004) The biomechanics of patellofemoral stability. J Knee Surg 17(1):35–39
Bicos J, Fulkerson JP, Amis A (2007) Current concepts review: the medial patellofemoral ligament. Am J Sports Med 35:484–492
Buckens CFM, Saris DBF (2010) Reconstruction of the medial patellofemoral ligament for treatment of patellofemoral instability: a systematic review. Am J Sports Med 38:181–188
Carrillon Y, Abidi H, Dejour D et al (2000) Patellar instability: assessment on MR images by measuring the lateral trochlear inclination-initial experience. Radiology 216(2):582–585
Dodson CC, Shindle MK, Dines JS, Altchek DW (2010) Arthroscopic suture anchor repair for lateral patellar instability. Knee Surg Sports Traumatol Arthrosc 18(2):143–146
Halbrecht JL (2001) Arthroscopic patella realignment: an all-inside technique. Arthroscopy 17(9):940–945
Haspl M, Cicak N, Klobucar H, Pecina M (2002) Fully arthroscopic stabilization of the patella. Arthroscopy 18(1):E2
Henry JE, Pflum FA Jr (1995) Arthroscopic proximal patella realignment and stabilization. Arthroscopy 11(4):424–425
Kepler CK, Bogner EA, Hammoud S, Malcolmson G, Potter HG, Green DW (2011) Zone of injury of the medial patellofemoral ligament after acute patellar dislocation in children and adolescents. Am J Sports Med 39(7):1444–1449
Sallay PI, Poggi J, Speer KP, Garrett WE (1996) Acute dislocation of the patella: a correlative pathoanatomic study. Am J Sports Med 24(1):52–60
Sanders TG, Morrison WB, Singleton BA, Miller MD, Cornum KG (2001) Medial patellofemoral ligament injury following acute transient dislocation of the patella: MR findings with surgical correlation in 14 patients. J Comput Assist Tomogr 25(6):957–962
Small NC, Glogau AI, Berezin MA (1993) Arthroscopically assisted proximal extensor mechanism realignment of the knee. Arthroscopy 9(1):63–67
Spritzer CE, Courneya DL, Burk DL Jr, Garrett WE, Strong JA (1997) Medial retinacular complex injury in acute patellar dislocation: MR findings and surgical implications. AJR Am J Roentgenol 168(1):117–122
Yamamoto RK (1986) Arthroscopic repair of the medial retinaculum and capsule in acute patellar dislocations. Arthroscopy 2(2):125–131
Zhao J, Huangfu X, He Y, Liu W (2012) The role of medial retinaculum plication versus medial patellofemoral ligament reconstruction in combined procedures for recurrent patellar instability in adults. Am J Sports Med 40:1355–1364
Ma LF, Wang F, Chen BC, Wang CH, Zhou JW, Wang HY (2013) Medial retinaculum plasty versus medial patellofemoral ligament reconstruction for recurrent patellar instability in adults: a randomized controlled trial. Arthroscopy 29(5):891–897
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Barkatali, B.M., Lea, M., Aster, A. et al. Arthroscopic medial capsular plication using the suture anchor technique. Knee Surg Sports Traumatol Arthrosc 22, 2513–2517 (2014). https://doi.org/10.1007/s00167-014-3001-x
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DOI: https://doi.org/10.1007/s00167-014-3001-x