MPFL Reconstruction Effective in Patellofemoral Instability with Trochlear Dysplasia

    Although a first-time patellar dislocation can usually be treated non-surgically, recurring dislocations often necessitate surgical intervention. Medial patellofemoral ligament (MPFL) reconstructions have become a common surgical option, resulting in improved outcomes and a high rate of return to sport.

    However, it was previously unknown if this procedure would be effective for people with trochlear dysplasia, which commonly occurs in patients with recurrent patellofemoral instability.

    A new study from Hospital for Special Surgery (HSS), presented at the 2017 Annual Meeting of the American Academy of Orthopaedic Surgeons, sought to determine if isolated MPFL reconstructions are a viable option for patients with trochlear dysplasia, sparing these patients larger, more complicated bony procedures.

    The study was a retrospective review of 105 patients who underwent MPFL reconstructions and had a 10-year follow-up. Patient outcomes scores were high – 87.2 on the Kujala Anterior Knee Pain Scale – and 89% of those who had participated in sports preoperatively returned to sports within 1 year after surgery. The success rate was 97%, with only 3 patients reporting a postoperative dislocation.

    “As surgeons, we like to do the least-invasive surgery possible to fully fix the problem,” said Beth E. Shubin Stein, MD, sports medicine surgeon at HSS and the study’s lead investigator. “With this study, we found that MPFL reconstruction is a safe and effective treatment for patients with patellofemoral instability, even if in patients who have trochlear dysplasia.

    “Equally as important, we showed that this technique can be done in patients who might previously be advised to undergo a bony procedure such as tibial tubercle osteotomy or trochleoplasty, which can be high-risk surgeries.”