title: Clinical and Functional Outcomes following Primary Repair versus Reconstruction of the Medial Patellofemoral Ligament for Recurrent Patellar Instability.
abstract: Background. The purpose of this study was to compare outcomes of medial patellofemoral ligament (MPFL) repair or reconstruction. Methods. Fourteen knees that underwent MPFL repair and nine (F5, M4) knees that underwent reconstruction at our institution were evaluated for objective and subjective outcomes. The mean age at operation was 20.1 years for repair and 19.8 years for reconstruction. All patients had a minimum of 2 years of follow-up (range: 24-75 months). Patient subjective outcomes were obtained using the International Knee Documentation Committee (IKDC) and Kujala patellofemoral subjective evaluations, as well as Visual Analog (VAS) and Tegner Activity Scales. Bilateral isometric quadriceps strength and vastus medialis obliquus (VMO) and vastus lateralis (VL) surface EMG were measured during maximal isometric quadriceps contractions at 30° and 60° of flexion. Results. There were no redislocations in either group. There was no difference in IKDC (P = 0.16), Kujala (P = 0.43), Tegner (P = 0.12), or VAS (P = 0.05) scores at follow-up. There were no differences between repair and reconstruction in torque generation of the involved side at 30° (P = 0.96) and 60° (P = 0.99). In addition, there was no side to side difference in torque generation or surface EMG activation of VL or VMO. Conclusions. There were minimal differences found between patients undergoing MPFL repair and MPFL reconstruction for the objective and subjective evaluations in this study.
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Suite R200, Minneapolis, MN 55454, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Tompkins
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA 22908, USA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Kuenze
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA 22908, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Diduch
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA 22908, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Miller
authors.affiliation: Elite Sports Medicine, Connecticut Children's Medical Center, Hartford, CT 06032, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Milewski
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA 22908, USA.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Hart