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Preliminary results of two surgical techniques in the treatment of recurrent patellar dislocation

Medial patellofemoral ligament reconstruction versus combined technique of vastus medialis advancement, capsular plasty and Roux-Goldthwait procedure in treatment of recurrent patellar dislocation

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Abstract

Purpose

Recurrent patellar dislocation is defined as a dislocation occurring more than once. There is no consensus as to the choice of operative technique for recurrent dislocation in adolescents. Recently, great importance has been attributed to MPFL reconstruction. The aim of this study is to evaluate the value of MPFL reconstruction (group A) in adolescents by comparing MPFL reconstruction with combined soft tissue proximal and distal alignment (group B).

Methods

MPFL reconstruction by means of Avikainen’s technique was performed on 32 knees. Another 33 knees were subject to the techniques combining retinacular plasty, vastus medialis advancement, and Roux-Goldthwait procedure. The results were assed clinically (Lyscholm scale and the Kujala Anterior Knee Pain Scale) and using X-rays (axial and lateral knee view). Isokinetic assessment of the quadriceps and hamstring was performed.

Results

No statistically significant differences between the two groups were observed regarding the Lyscholm and Kujala scales, the presence of redislocation (9.3 % for group A versus 12.1 % for group B), apprehension test, abnormal patellofemoral angle, abnormal Caton index (p > 0.05). A statistically significant difference between the groups was observed regarding the rate of pain complaints, the incidence of an abnormal congruence angle, patellar medialization and deficits in the peak torque of the hamstring between the two angular velocities (p < 0.05).

Conclusions

The redislocation rates risk is similar in both groups. However, a lower incidence of pain complaints in the group of patients with MPFL reconstruction favours the use of MPFL reconstruction as the first choice technique.

Level of evidence: III

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Acknowledgments

The authors are grateful to Daniel Cybula (Strzeminski Academy of Fine Arts Lodz) for preparing pictures.

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Authors and Affiliations

  1. Clinic of Orthopaedic and Traumatology, Polish Mother’s Memorial Hospital Research Institute, Rzgowska 281/289, 93-338, Lodz, Poland

    Krzysztof Malecki, Pawel Flont, Zbigniew Lipczyk & Kryspin Niedzielski

  2. Department of Arthroscopy, Minimally Invasive Surgery and Sports Traumatology, Medical University of Lodz, Żeromskiego 113, 90-549, Lodz, Poland

    Jarosław Fabis

Authors
  1. Krzysztof Malecki
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  2. Jarosław Fabis
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  3. Pawel Flont
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  4. Zbigniew Lipczyk
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  5. Kryspin Niedzielski
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Corresponding author

Correspondence to Pawel Flont.

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Funding

This work was sponsored by the Polish Ministry of Science & Higher Education, Polish Mother’s Memorial Hospital Research Institute Young Researcher Internal Grant No. 2012/59-MN.

Conflict of interest

The authors declare that there is no conflict of interests regarding the publication of this paper.

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Malecki, K., Fabis, J., Flont, P. et al. Preliminary results of two surgical techniques in the treatment of recurrent patellar dislocation. International Orthopaedics (SICOT) 40, 1869–1874 (2016). https://doi.org/10.1007/s00264-016-3119-1

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  • DOI: https://doi.org/10.1007/s00264-016-3119-1

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