Clinical Comparison of Medial Patellofemoral Ligament Reconstruction With or Without Tibial Tuberosity Transfer for Recurrent Patellar Instability
DC Field | Value | Language |
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dc.contributor.author | Kim, Jong-Min | - |
dc.contributor.author | Sim, Jae-Ang | - |
dc.contributor.author | Yang, HongYeol | - |
dc.contributor.author | Kim, Young-Mo | - |
dc.contributor.author | Wang, Joon-Ho | - |
dc.contributor.author | Seon, Jong-Keun | - |
dc.date.accessioned | 2021-10-09T03:03:18Z | - |
dc.date.available | 2021-10-09T03:03:18Z | - |
dc.date.created | 2021-09-17 | - |
dc.date.issued | 2021-10 | - |
dc.identifier.issn | 0363-5465 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/82340 | - |
dc.description.abstract | Background: No clear guidelines or widespread consensus has defined a threshold value of tibial tuberosity–trochlear groove (TT-TG) distance for choosing the appropriate surgical procedures when additional tibial tuberosity osteotomy (TTO) should be added to augment medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar instability. Purpose: To compare the clinical outcomes between MPFL reconstruction and MPFL reconstruction with TTO for patients who have patellar instability with a TT-TG distance of 15 to 25 mm. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively analyzed 81 patients who underwent surgical treatment using either MPFL reconstruction or MPFL reconstruction with TTO for recurrent patellar instability with a TT-TG distance of 15 to 25 mm; the mean follow-up was 25.2 months (range, 12.0-53.0 months). The patients were divided into 2 groups: isolated MPFL reconstruction (iMPFL group; n = 36) performed by 2 surgeons and MPFL reconstruction with TTO (TTO group; n = 45) performed by another 2 surgeons. Clinical outcomes were assessed using the Kujala score, Knee injury and Osteoarthritis Outcome Score, and Tegner activity score. Radiological parameters, including patellar height, TT-TG distance, patellar tilt, and congruence angle were compared between the 2 groups. Functional failure based on clinical apprehension sign, repeat subluxation or dislocation, and subjective instability and complications was assessed at the final follow-up. We also compared clinical outcomes based on subgroups of preoperative TT-TG distance (15 mm ≤ TT-TG ≤ 20 mm vs 20 mm < TT-TG ≤ 25 mm). Results: All of the clinical outcome parameters significantly improved in both groups at the final follow-up (P <.001), with no significant differences between groups. The radiological parameters also showed no significant differences between the 2 groups. The incidence of functional failure was similar between the 2 groups (3 failures in the TTO group and 2 failures in the iMPFL group; P =.42). In the TTO group, 1 patient experienced a repeat dislocation postoperatively and 2 patients had subjective instability; in the iMPFL group, 2 patients had subjective instability. The prevalence of complications did not differ between the 2 groups (P =.410). In the subgroup analysis based on TT-TG distance, we did not note any differences in clinical outcomes between iMPFL and TTO groups in subgroups of 15 mm ≤ TT-TG ≤ 20 mm and 20 mm < TT-TG ≤ 25 mm. Conclusion: MPFL reconstruction with and without TTO provided similar, satisfactory clinical outcomes and low redislocation rates for patients who had patellar instability with a TT-TG distance of 15 to 25 mm, without statistical difference. Thus, our findings suggest that iMPFL reconstruction is a safe and reliable treatment for patients with recurrent patellar dislocation with a TT-TG distance of 15 to 25 mm, without the disadvantages derived from TTO. © 2021 The Author(s). | - |
dc.language | 영어 | - |
dc.language.iso | en | - |
dc.publisher | SAGE Publications Inc. | - |
dc.relation.isPartOf | American Journal of Sports Medicine | - |
dc.title | Clinical Comparison of Medial Patellofemoral Ligament Reconstruction With or Without Tibial Tuberosity Transfer for Recurrent Patellar Instability | - |
dc.type | Article | - |
dc.type.rims | ART | - |
dc.description.journalClass | 1 | - |
dc.identifier.wosid | 000694685300001 | - |
dc.identifier.doi | 10.1177/03635465211037716 | - |
dc.identifier.bibliographicCitation | American Journal of Sports Medicine, v.49, no.12, pp.3335 - 3343 | - |
dc.description.isOpenAccess | N | - |
dc.identifier.scopusid | 2-s2.0-85114665359 | - |
dc.citation.endPage | 3343 | - |
dc.citation.startPage | 3335 | - |
dc.citation.title | American Journal of Sports Medicine | - |
dc.citation.volume | 49 | - |
dc.citation.number | 12 | - |
dc.contributor.affiliatedAuthor | Sim, Jae-Ang | - |
dc.type.docType | Article in Press | - |
dc.subject.keywordAuthor | MPFL | - |
dc.subject.keywordAuthor | patellar instability | - |
dc.subject.keywordAuthor | recurrent | - |
dc.subject.keywordAuthor | TTO | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
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