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Radiographic Parameters Predicting Outcomes Following Medial Patellofemoral Ligament Reconstruction And Tibial Tubercle Osteotomy In The Treatment Of Patellar Instability

Edward Stephen Mojica, BS, UNITED STATES Mohammad Samim, MD, UNITED STATES Danielle Heather Markus, BA, UNITED STATES Ariana Lott, MD, UNITED STATES Eric Jason Strauss, MD Laith M. Jazrawi, MD, UNITED STATES Michael J Alaia, MD, UNITED STATES Erin Alaia, MD, UNITED STATES

NYU Langone, New York, New York, UNITED STATES

2021 Congress ePoster Presentation Not yet rated

Anatomic Location

Knee Patellofemoral

Diagnosis / Condition

Dislocation

Patellofemoral

Acute Patella Dislocation Recurrent Subluxation and Dislocation Patellofemoral Ligament Rupture

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Summary: This analysis of radiographic parameters suggests that patellar tilt is significantly associated with post-operative subluxation in patients undergoing concomitant MPFLR and TTO for treatment of patellar instability.

Background

Medial patellofemoral ligament reconstruction (MPFLR) is a safe and effective treatment option for recurrent lateral patellar instability. Although prior studies have reported varied radiographic predictors of failure following MPFLR, no known study has reported significant predictive parameters after combined MPFLR and tibial tubercle osteotomy (TTO). The purpose of this study is to investigate whether radiographic parameters can help predict recurrent instability and outcomes after MPFLR with TTO.

Methods

Patients who underwent MPFLR with TTO from 2010 to 2019 were followed for a minimum of 12 months from surgery. All patients completed patient-reported outcome (PRO) scores, and self-reported recurrent subluxation/dislocation events. Pre-operative images were assessed for patellar tilt, patellar height, tibial tuberosity to trochlear groove distance (TT-TG), and trochlear dysplasia. Radiographic parameters and demographic information (sex, BMI) were analyzed for correlation with PRO’s and post-operative patellar instability events.

Results

The study included 48 knees undergoing MPFLR with TTO. 77.1% of the cohort was female, with a mean age of 26.3 ± 9.2 (range 15 – 56 years). Mean duration of follow up was 45.8 months. There were 9 self-reported subluxation events (18.8%). Patellar tilt was found to have a statistically significant relationship with subluxation events (p = 0.030). TT-TG was found to have a significant relationship with post-operative increase in satisfaction (p = 0.029) and increase in Kujala (p = 0.027).

Conclusion

This analysis of radiographic parameters suggests that patellar tilt is significantly associated with post-operative subluxation in patients undergoing concomitant MPFLR and TTO for treatment of patellar instability.

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Radiographic Parameters Predicting Outcomes Following Medial Patellofemoral Ligament Reconstruction And Tibial Tubercle Osteotomy In The Treatment Of Patellar Instability

Radiographic Parameters Predicting Outcomes Following Medial Patellofemoral Ligament Reconstruction And Tibial Tubercle Osteotomy In The Treatment Of Patellar Instability

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Conclusion

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Radiographic Parameters Predicting Outcomes Following Medial Patellofemoral Ligament Reconstruction And Tibial Tubercle Osteotomy In The Treatment Of Patellar Instability

Radiographic Parameters Predicting Outcomes Following Medial Patellofemoral Ligament Reconstruction And Tibial Tubercle Osteotomy In The Treatment Of Patellar Instability

Background

Methods

Results

Conclusion