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Medial retinaculum reefing for the treatment for patellar instability

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Medial structures repair is a well-established approach in the treatment for patellar instability. However, the literature is confusing concerning the indications for surgery, the different surgical techniques and outcomes. The goal of this systematic review was to clarify the indications for medial structures repair and to analyse the results of both arthroscopic and open techniques.

Methods

A comprehensive literature review was performed using the keywords ‘patellar instability’, ‘medial capsule reefing’ and ‘medial capsule plication’ with no limit regarding the year of publication. All the selected articles in Anglo-Saxon language were evaluated with the Coleman methodology score.

Results

Seventeen full-text articles were evaluated. Initial cohort included 617 patients. About 569 patients were reviewed at an average FU of 54.6 months (range 2–165 months) after medial structures repair. Average age at the time of surgery was 21.2 years (range 9–65 years). The indications for surgery included both patellar subluxation and dislocation (acute or chronic). Average Kujala score increased from 55 to 84 at the last FU, and in the same way average Lysholm score increased from 41.2 to 80.5, whereas average Tegner score increased from 3 to 5.3 and IKDC score from 47.8 to 75.1. Re-dislocation rate among the series was 6.1 %. Average Coleman methodology score was 61.6 (range 17–92).

Conclusion

From this review, it emerges that medial capsule reefing is a reliable option in the treatment for patellar instability. It can be proposed with good expectations, since the outcomes are positive and stable even at longer FU and complications rates are low. Re-dislocation rate is variable and can occur in up to one-third of patients. However, most of the available studies are case series, and comparison of the series is hard since they widely differ in inclusion criteria and indications, surgical technique and additional procedures, and outcome measures.

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Authors and Affiliations

  1. Albert Trillat Center, Lyon North University Hospital, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France

    Simone Cerciello, Sebastien Lustig & Philippe Neyret

  2. Università La Sapienza-Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy

    Giuseppe Costanzo

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  1. Simone Cerciello
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  2. Sebastien Lustig
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  3. Giuseppe Costanzo
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  4. Philippe Neyret
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Correspondence to Simone Cerciello.

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Cerciello, S., Lustig, S., Costanzo, G. et al. Medial retinaculum reefing for the treatment for patellar instability. Knee Surg Sports Traumatol Arthrosc 22, 2505–2512 (2014). https://doi.org/10.1007/s00167-014-3171-6

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  • DOI: https://doi.org/10.1007/s00167-014-3171-6

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