title: Clinical outcome in MPFL reconstruction with and without tuberositas transposition.
abstract: OBJECTIVE
  There are several surgical options for recurrent patella dislocations. As the reconstruction of the medial patellofemoral ligament (MPFL) has been proven to restore stability, it has become more accepted. Aim of this study was to investigate the clinical outcome after MPFL reconstruction as an isolated procedure or in association with a transposition of the tibial tubercle (in case of patella alta or an excessive TT-TG) in a large prospective cohort study. Additionally, the effect on patellar height was analysed radiographically using the Caton-Deschamps index.
  
  
  METHODS
  In a large prospective cohort study of 129 knees in 124 patients (81 females, 48 males, mean age 22.8 ± 7.7 years), 91 knees received primary MPFL reconstruction (group 1) and 38 were a combination with a transposition of the tibial tubercle (group 2). The clinical follow-up was evaluated using KOOS and Kujala scores preoperatively and 1 year postoperatively. Patient satisfaction, complications and revision surgery were recorded.
  
  
  RESULTS
  Overall, Kujala improved significantly from 53.5 (SD 22.7) preoperatively to 74.7 (SD 20.5) postoperatively (p < 0.01). All KOOS subdomains improved significantly (p < 0.01). No significant difference for Kujala score between groups was noticed. Revision rate was (5/129) 3.9 %. Reconstruction was supplemented with a transfer of the tibial tuberosity in (38/129) 29.4 % of the cases and shows a comparable outcome.
  
  
  CONCLUSIONS
  MPFL reconstruction is a viable treatment option for episodic patellar dislocation. A concomitant tuberositas transposition is useful in selected patients.
  
  
  METHODS
  I.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Mulliez
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. delphine.lambrecht@ugent.be.
authors.forename: D
authors.identifier: http://orcid.org/0000-0002-1780-4449
authors.initials: D
authors.lastname: Lambrecht
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Verbruggen
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Van Der Straeten
authors.affiliation: Department of Physiotherapy and Orthopaedic Surgery, Faculty of Medicine, Ghent University, Ghent, Belgium.|Department of Orthopaedic Surgery, Monica Hospitals, Antwerp, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Verdonk
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Victor
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D031222:Patellar Dislocation / Q000601:surgery*; D057071:Patellofemoral Joint / Q000601:surgery*; D017060:Patient Satisfaction; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation / Q000706:statistics & numerical data; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: MPFL; Medial patellofemoral ligament; Patellar instability; Tibial tuberosity transfer