title: Medial patellofemoral ligament reconstruction for patellar instability in patients with hypermobility: a case control study.
abstract: Hypermobility is an acknowledged risk factor   for patellar instability. In this case control study the influence   of hypermobility on clinical outcome following medial patellofemoral   ligament (MPFL) reconstruction for patellar instability was studied. A total of 25 patients with hypermobility as determined by the   Beighton criteria were assessed and compared with a control group   of 50 patients who were matched for age, gender, indication for   surgery and degree of trochlear dysplasia. The patients with hypermobility   had a Beighton Score of ≥ 6; the control patients had a score of <   4. All patients underwent MPFL reconstruction performed using semitendinosus   autograft and a standardised arthroscopically controlled technique.   The mean age of the patients was 25 years (17 to 49) and the mean   follow-up was 15 months (6 to 30). Patients with hypermobility had a significant improvement in   function following surgery, with reasonable rates of satisfaction,   perceived improvement, willingness to repeat and likelihood of recommendation.   Functional improvements were significantly less than in control   patients (p < 0.01). Joint hypermobility is not a contraindication to MPFL reconstruction   although caution is recommended in managing the expectations of   patients with hypermobility before consideration of surgery.
authors.affiliation: Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, UK. nickrhowells@yahoo.co.uk
authors.forename: N R
authors.initials: NR
authors.lastname: Howells
authors.forename: J D
authors.initials: JD
authors.lastname: Eldridge
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000150:complications / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D031222:Patellar Dislocation / Q000209:etiology / Q000601:surgery*; D057071:Patellofemoral Joint / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult