%0 Journal Article
%T Clinical and Functional Outcomes following Primary Repair versus Reconstruction of the Medial Patellofemoral Ligament for Recurrent Patellar Instability
%A Marc Tompkins
%A Christopher M. Kuenze
%A David R. Diduch
%A Mark D. Miller
%A Matthew D. Milewski
%A Joseph P. Hart
%J Journal of Sports Medicine
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/702358
%X 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每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 ( ), Kujala ( ), Tegner ( ), or VAS ( ) scores at follow-up. There were no differences between repair and reconstruction in torque generation of the involved side at 30∼ ( ) and 60∼ ( ). 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. 1. Introduction Patellar instability poses a difficult treatment problem in the setting of recurrent instability [1]. Many types of operative management to address injury to the medial patellofemoral ligament (MPFL) have been described [2]. These include repair of the MPFL, which has been described using arthroscopic, arthroscopically assisted, or open techniques [3每6]. When the pathology is within the midsubstance of the tendon such as chronic stretching of the MPFL, imbrication has been described where the fibers of the MPFL are tightened [7每12]. Finally, when repair and imbrication are not possible or not recommended, reconstruction of the MPFL using various techniques has been described [13每22]. Long term clinical studies evaluating management options for patellar instability have come in many forms. In recurrent patellar instability or chronic injury to the MPFL, repair of the MPFL has provided mixed clinical results [23每34]. Reconstruction of the MPFL in recurrent patellar instability has been evaluated in many long term studies with good results, in general [13, 18, 25每33]. All of the techniques for repair or reconstruction come with
%U http://www.hindawi.com/journals/jsm/2014/702358/