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International Orthopaedics

, Volume 43, Issue 6, pp 1495–1501 | Cite as

Surgical medial patellofemoral ligament reconstruction versus non-surgical treatment of acute primary patellar dislocation: a prospective controlled trial

  • Xiaozuo ZhengEmail author
  • Yang Hu
  • Peng Xie
  • Meijuan Cui
  • Xuelin Ma
  • Yu-e Feng
  • Juyuan Gu
  • Shijun GaoEmail author
Original Paper
  • 204 Downloads

Abstract

Purpose

The acute primary (first-time) lateral patellar dislocation is associated with a high rate of functional disability. There is no consensus as to the choice of surgical or non-surgical treatment for these patients. The aim of this study is to compare the clinical results between the surgical (reconstruction of the medial patellofemoral ligament [MPFL]) and non-surgical treatments for acute primary patellar dislocations.

Methods

Sixty-nine skeletally mature patients (69 knees) were included in this prospective non-randomized controlled trial. At least one predisposing factor for patellar dislocation (including patella alta, high lateral patellar tilt, trochlear dysplasia, and increased TT-TG distance) was identified in the included patients. Thirty patients were treated surgically with MPFL reconstruction, and the other 39 patients were treated non-surgically. The main outcome variable was patellar redislocation within a two year follow-up period. The Kujala questionnaire was applied for analyzing the pain and the quality of life. The additional surgeries due to patellofemoral problems were also recorded.

Results

Patellar redislocation occurred in eight patients in the non-surgical group, while no redislocation occurred in the surgical group (P < 0.05). Four patients in non-surgical group underwent further surgery due to patellar redislocation and poor function during the follow-up period. The Kujala score and the percentage of “good/excellent” results on the Kujala score of the surgical group were significantly better than that of the non-surgical group (P < 0.05).

Conclusions

The surgical MPFL reconstruction achieved better clinical outcomes compared with non-surgical treatment for the acute primary patellar dislocation in the skeletally mature patients with the presence of abnormal patellofemoral anatomy. Surgery should be considered as the better choice for these specific patients.

Keywords

Medial patellofemoral ligament MPFL reconstruction Acute primary patellar dislocation 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict interest.

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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Xiaozuo Zheng
    • 1
    • 2
    Email author
  • Yang Hu
    • 3
  • Peng Xie
    • 2
    • 4
  • Meijuan Cui
    • 2
    • 5
  • Xuelin Ma
    • 1
    • 2
  • Yu-e Feng
    • 1
    • 2
  • Juyuan Gu
    • 1
    • 2
  • Shijun Gao
    • 1
    • 2
    Email author
  1. 1.Department of OrthopedicsThird Hospital of Hebei Medical UniversityShijiazhuangChina
  2. 2.Key Laboratory of Biomechanics of Hebei ProvinceShijiazhuangChina
  3. 3.The Second Department of Intensive Care UnitChildren’s Hospital of Hebei ProvinceShijiazhuangChina
  4. 4.Department of Nuclear medicineThird Hospital of Hebei Medical UniversityShijiazhuangChina
  5. 5.Department of medical recordsThird Hospital of Hebei Medical UniversityShijiazhuangChina

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