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The Relationship of Femoral Tunnel Positioning in Medial Patellofemoral Ligament Reconstruction on Clinical Outcome and Postoperative Complications
- Source :
- Arthroscopy: The Journal of Arthroscopic & Related Surgery. 34:2410-2416
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Purpose To analyze the relation of the femoral tunnel (FT) positioning on clinical outcome. Methods Patients with recurrent patellar dislocation who underwent medial patellofemoral ligament (MPFL) reconstruction with or without tibial tubercle osteotomy between 1998 and 2012 were included in this retrospective study. Strict postoperative lateral radiographs were mandatory. Knees with previous osseous stabilization surgery, fixed lateral patellar dislocation, valgus knee (>5°), or open growth plates were excluded. The distance between the FT and the validated radiographic landmark (the "Schoettle point") was measured. An FT with a distance greater than 10 mm was considered as malpositioned. The distance was correlated to subjective outcome measurements (patient satisfaction and Kujala score) and postoperative complications (a loss of range of motion and revision surgery). Results Sixty-three knees in 60 patients (aged 23.7 ± 7.5 years at the time of surgery, 79.4% female) were included with a mean follow-up of 5.7 ± 3.3 years. The FT showed an average distance of 13.3 mm (±6.0 mm; 95% confidence interval [CI]: 11.7-14.8) to the Schoettle point, and 45 of 63 knees (71.4%) were deemed malpositioned. The postoperative Kujala score of malpositioned FT (75.9 points; 95% CI: 71.2-80.7) was not significantly inferior to knees with an FT within 10 mm (80.5; 95% CI: 73.7-87.3, P = .315). However, all 5 knees that underwent revision surgery showed an FT outside the 10-mm area. Conclusions Malpositioning of the FT in MPFL reconstruction is associated with postoperative complications. However, a malpositioned FT in MPFL reconstruction will not necessarily lead to an unsatisfactory subjective or objective clinical outcome. Other factors, such as surgical indication or graft tensioning, might also significantly influence postoperative outcome. Level of Evidence Level IV, case-control study.
- Subjects :
- Male
Reoperation
medicine.medical_specialty
Knee Joint
Patellar Dislocation
medicine.medical_treatment
Radiography
Medial patellofemoral ligament
Osteotomy
Young Adult
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Patient satisfaction
Humans
Medicine
Orthopedics and Sports Medicine
Femur
Postoperative Period
Range of Motion, Articular
Retrospective Studies
030222 orthopedics
biology
business.industry
Incidence
Retrospective cohort study
030229 sport sciences
Plastic Surgery Procedures
biology.organism_classification
Confidence interval
Surgery
Valgus
medicine.anatomical_structure
Ligaments, Articular
Female
business
Range of motion
Switzerland
Subjects
Details
- ISSN :
- 07498063
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- Arthroscopy: The Journal of Arthroscopic & Related Surgery
- Accession number :
- edsair.doi.dedup.....99f1021d75259b60984fef718bd4ada7