Purpose: The purpose of this study was to evaluate the effect of surgical reinsertion of the
medial patellofemoral ligament (MPFL) to the adductor tubercle compared with conservative
treatment in patients with primary dislocation of the patella. Methods: Eighty patients with primary patella dislocation were included in the study. Delayed
arthroscopy (mean, 50 days after injury) was performed to assess cartilage injury
and status. During arthroscopy, patients were randomized to surgical reinsertion of
the MPFL or to conservative treatment. Conservative treatment was use of a brace with
0° to 20° motion for the first 2 weeks after dislocation. Patients were followed up
for 2 years. The incidence of recurrent patella dislocation was recorded along with
the clinical Kujala scores and Knee Injury and Osteoarthritis Outcome Scores. Results: The redislocation rates were 17% and 20% in the operative and conservative treatment
groups, respectively (P = not significant). Kujala scores were 85 and 78 in the operative and conservative
treatment groups, respectively (P = .07). The patella stability subscore was significantly higher in the operative
group. No difference in Knee Injury and Osteoarthritis Outcome Scores was found. Conclusions: Delayed primary repair of the MPFL by use of an anchor-based reattachment to the
adductor tubercle without vastus medialis obliquus repair after primary patella dislocation
does not reduce the risk of redislocation nor does it produce any significantly better
subjective functional outcome based on the Kujala knee score. Only the specific subjective
patella stability score was improved by MPFL repair compared with conservative treatment.
Level of Evidence: Level I, therapeutic randomized controlled trial.
Key Words
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Article info
Publication history
Accepted:
March 13,
2008
Received:
November 29,
2007
Footnotes
Recipient of the Patellofemoral Excellence Award at the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine 2007 meeting, Florence, Italy.
The authors report no conflict of interest.
Identification
Copyright
© 2008 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
