Open AccessMedial patellofemoral ligament (MPFL) reconstruction in combination with a modified grammont technique leads to favorable mid‐term results in adolescents with recurrent patellofemoral dislocations
Author(s) -
Wegmann Helmut,
Würnschimmel Christoph,
Kraus Tanja,
Singer Georg,
Eberl Robert,
Till Holger,
Sperl Matthias
Publication year - 2018
Publication title -
knee surgery, sports traumatology, arthroscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.806
H-Index - 125
eISSN - 1433-7347
pISSN - 0942-2056
DOI - 10.1007/s00167-017-4425-x
Subject(s) - medial patellofemoral ligament , medicine , patella , surgery , dysplasia , tibial tuberosity
Purpose The aim of the present study is to present the outcome of a cohort of adolescent patients with trochlear dysplasia and elevated tibial tuberosity trochlear groove (TTTG) distance suffering from recurrent patellar dislocation. Treatment consisted of medial patellofemoral ligament (MPFL) reconstruction and a modified Grammont procedure. Methods MRI examinations were obtained pre‐ and postoperatively. Trochlear dysplasia was classified according to Déjour, and TTTG was measured on MRI. The Tegner Activity Scale and the Kujala Knee Score were assessed preoperatively and at follow‐up. The Kujala Knee score and the IKDC 2000 knee score were documented at follow‐up (median 50, range 20–61 months; SD 16.6). Results Seven knees of six patients (median age 16.5 years, range 14–17 years) with trochlear dysplasia and elevated TTTG distance (median 17 mm, range 16.1–21.9 mm; SD 2.8) were treated. Trochlear dysplasia was classified as Déjour type A in 1, type B in 5, and type C in 1 knee. The Kujala Knee Score significantly increased from values of 55 (range 17–88; SD 25.9) to 94 (range 73–100; SD 9.1) at follow‐up ( p = 0.028). TAS improved from preoperative 2 (range 0–7; SD 2.5) to 5 (range 4–9; SD 1.8) at follow‐up ( p = 0.034). Median IKDC 2000 Knee Score at follow‐up was 89 (range 61–100, SD 13.4). No re‐dislocations were encountered. Conclusion In selected adolescents with recurrent patellofemoral instability, MPFL reconstruction in combination with a modified Grammont technique yields excellent functional outcome and could, therefore, help to avoid major procedures, such as osteotomies. Level of evidence Therapeutic, Level IV.