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Archives of Orthopaedic and Trauma Surgery

, Volume 137, Issue 8, pp 1087–1095 | Cite as

Surgical treatment of patellar instability: clinical and radiological outcome after medial patellofemoral ligament reconstruction and tibial tuberosity medialisation

  • Stefan LobnerEmail author
  • Christine Krauss
  • Frank Reichwein
  • Thilo Patzer
  • Wolfgang Nebelung
  • Arne J. Venjakob
Arthroscopy and Sports Medicine

Abstract

Introduction

The aim of this retrospective study was to analyse clinical and radiological outcome after medial patellofemoral ligament reconstruction (MPFLR) and tibial tuberosity medialisation (TTM) in patients with recurrent patellar instability.

Materials and methods

Thirty-five patients were included between 2008 and 2012. According to defined criteria such as tibial tuberosity-trochlear groove (TTTG) distance, hyperpression on the lateral patella facet and lateral retropatellar cartilage damage either MPFLR (group A) or TTM (group B) was performed: 18 patients underwent TTM, the other 17 patients underwent MPFLR. At a mean of 25.4 ± 9.7 (group A) and 35.2 ± 17.6 months (group B) patients were clinically and radiologically reviewed. Validated knee scores such as Kujala, Lysholm and Tegner score were evaluated.

Results

In both groups one patient reported of a non-traumatic patellar redislocation. Patients who underwent MPFLR (group A) had less pain postoperatively during activity according to the Visual Analogue Scale (group A: 2.0 ± 2.1 points, group B: 3.9 ± 2.3 points). Retropatellar cartilage damage increased in group B from grade 1 (range: 1–3) preoperatively to grade 2 (range 1–3) postoperatively (p > 0.05). All other clinically evaluated items, as well as the applied knee scoring systems, indicated no significant difference (p > 0.05) and displayed good to excellent results.

Conclusions

MPFLR and TTM leed to good clinical results despite its own indications. For this reason—in selected cases—TTM may still be a suitable procedure for surgical treatment of patellar instability. However, patients treated by TTM (group B) revealed an increased retropatellar cartilage damage as well as significantly more pain during activity.

Keywords

Patellar instability Recurrent patellar dislocation MPFL reconstruction Tibial tuberosity transfer 

Notes

Compliance with ethical standards

Conflict of interest

Author Stefan Lobner, Author Christine Krauss, Author Frank Reichwein, Author Thilo Patzer, Author Wolfgang Nebelung, and Author Arne J. Venjakob declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Stefan Lobner
    • 1
    • 3
    Email author
  • Christine Krauss
    • 2
    • 3
  • Frank Reichwein
    • 3
  • Thilo Patzer
    • 4
  • Wolfgang Nebelung
    • 3
  • Arne J. Venjakob
    • 3
  1. 1.Department of Orthopaedics, Trauma Surgery and Sports MedicineJohanna-Etienne Hospital NeussNeussGermany
  2. 2.Sports Clinic of StuttgartStuttgartGermany
  3. 3.Department of Rheumatology and ArthroscopyMarienkrankenhaus Duesseldorf-KaiserswerthDuesseldorfGermany
  4. 4.Department of OrthopaedicsUniversity Hospital of DuesseldorfDuesseldorfGermany

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