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Clinical outcomes of medial patellofemoral ligament reconstruction in patients with an increased tibial tuberosity–trochlear groove distance

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

Abstract

Purpose

Medial patellofemoral ligament (MPFL) reconstruction is performed to treat recurrent patellar dislocation (RPD). However, the effectiveness of MPFL reconstruction in patients with a severely lateralised tibial tuberosity remains unknown. In this study, the clinical outcomes of MPFL reconstruction in patients with an increased tibial tuberosity–trochlear groove (TT–TG) distance were examined.

Methods

A total of thirty-four patients who underwent MPFL reconstruction for RPD were retrospectively examined. Nineteen patients with a TT–TG distance of >20 mm (increased TT–TG distance group) were compared with 15 patients with a TT–TG distance of <20 mm (control group). Clinical outcomes of MPFL reconstruction were evaluated by occurrence of re-dislocation, Crosby and Insall grading system, apprehension sign, and Kujala and Lysholm scores.

Results

None of the patients reported re-dislocation. Apprehension sign remained in three patients in the increased TT–TG distance group and in one patient in the control group. According to the Crosby and Insall grading system, 9 patients (47 %) were excellent, 9 (47 %) were good, and 1 (5 %) was fair to poor in the increased TT–TG distance group, while 6 (40 %) were excellent and 9 (60 %) were good in the control group. Kujala and Lysholm scores were significantly improved post-operatively in both groups. No significant correlations were observed between TT–TG distance and post-operative Kujala or Lysholm score.

Conclusion

Overall clinical outcomes of MPFL reconstruction were favourable even in patients with an increased TT–TG distance. TT–TG distance of >20 mm may not be an absolute indication for medialisation of the tibial tuberosity when performing MPFL reconstruction.

Level of evidence

Case–control study, Level III.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan

    Takehiko Matsushita, Ryosuke Kuroda, Shinya Oka, Tomoyuki Matsumoto, Koji Takayama & Masahiro Kurosaka

Authors
  1. Takehiko Matsushita
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  2. Ryosuke Kuroda
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  3. Shinya Oka
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  4. Tomoyuki Matsumoto
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  5. Koji Takayama
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  6. Masahiro Kurosaka
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Correspondence to Ryosuke Kuroda.

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Matsushita, T., Kuroda, R., Oka, S. et al. Clinical outcomes of medial patellofemoral ligament reconstruction in patients with an increased tibial tuberosity–trochlear groove distance. Knee Surg Sports Traumatol Arthrosc 22, 2438–2444 (2014). https://doi.org/10.1007/s00167-014-2919-3

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