title: Patellofemoral chondral status after medial patellofemoral ligament reconstruction using second-look arthroscopy in patients with recurrent patellar dislocation.
abstract: BACKGROUND
  Most patients with recurrent patellar dislocation show cartilage damage in the patellofemoral joint. Medial patellofemoral ligament reconstruction has become one of the most important surgical techniques for treating recurrent patellar dislocation. However, patellofemoral chondral status after this reconstruction has not been elucidated. The purpose of this study was to investigate the effects of medial patellofemoral ligament reconstruction on articular cartilage in the patellofemoral joint by comparing the arthroscopic chondral status at the time of reconstruction with that at second-look arthroscopy.
  
  
  METHODS
  Participants in the present study comprised 31 patients (22 females, 9 males; 32 knees) who underwent second-look arthroscopy at a median of 12 months (range 6-40 months) after dual tunnel medial patellofemoral ligament reconstruction using a double-looped autologous semitendinosus tendon graft. Median age at the time of initial surgery was 20 years (range 13-43 years). The patellofemoral joint was divided into six portions, comprising the medial facet of the patella, central ridge, lateral facet of the patella, anterior medial femoral condyle, femoral groove, and anterior lateral femoral condyle. Chondral status in each portion according to the International Cartilage Repair Society classification was retrospectively evaluated at the time of initial surgery and second-look arthroscopy.
  
  
  RESULTS
  Before medial patellofemoral ligament reconstruction, chondral lesions were observed in the patellofemoral joint in 31 knees (97%). At the central ridge of the patella, chondral damage was observed in 22 knees (69%) at initial surgery and damaged cartilages showed recovery in 6 knees. No significant difference in the alteration of chondral status was seen for the medial facet, lateral facet of the patella, anterior medial femoral condyle, femoral groove, and anterior lateral femoral condyle.
  
  
  CONCLUSIONS
  According to short-term results, the patellofemoral chondral status after medial patellofemoral ligament reconstruction was not altered at second-look arthroscopy in most part of patellofemoral joint. At the central ridge of the patella, significant improvement of the International Cartilage Repair Society grading was observed.
authors.affiliation: Department of Sports Orthopaedics, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan, keikita@hera.eonet.ne.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kita
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Yukiyoshi
authors.initials: Y
authors.lastname: Toritsuka
authors.forename: Yasukazu
authors.initials: Y
authors.lastname: Yonetani
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Amano
authors.forename: Norimasa
authors.initials: N
authors.lastname: Nakamura
authors.forename: Shuji
authors.initials: S
authors.lastname: Horibe
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D002358:Cartilage, Articular / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D031222:Patellar Dislocation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017847:Patellar Ligament / Q000601:surgery*; D057071:Patellofemoral Joint / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D024162:Second-Look Surgery; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult