2015 ISAKOS Biennial Congress ePoster #1391

Anterior Cruciate Ligament (ACL) Reconstruction and Return to Sport Activity: Postural Control as the Key to Success

Rocco Papalia, MD, PhD, Prof., Rome ITALY
Francesco Franceschi, MD, PhD, Rome ITALY
Andrea Tecame, MD, Parma ITALY
Edoardo Franceschetti, MD, Rome ITALY
Lorenzo Alirio Diaz Balzani, MD, Roma ITALY
Stefano D'adamio, MS, Rome ITALY
Nicola Maffulli, MD, PhD, MS, FRCS(Orth), London UNITED KINGDOM
Vincenzo Denaro, MD, PhD, Prof., Rome ITALY

Akershus University Hospital, Lørenskog, NORWAY

FDA Status Not Applicable

Summary: The study compared the severity of the symptoms of patients with recurrent patella dislocations to symptoms reported by matched ACL injured controls and found that the patients with recurrent patella dislocation experience symptoms and function at the same level or inferior to the ACL injured scheduled for surgery

Rate:

Abstract:

Purpose

Patella dislocation is a serious knee injury with a peak incidence in the 10-17 year age group with a high prevalence of redislocations causing anxiety and loss of confidence in the knee. The purpose of the study was to compare the severity of the symptoms of patients with recurrent patella dislocations with those of ACL injured patients scheduled for surgery.

Method

Patients with two or more unilateral patella dislocations referred for reconstructive surgery of the medial patellofemoral ligament (MPFL) from May 2010 to May 2014 were included in the study (MPFL group). These cases were matched with two cases each obtained from the Norwegian Knee Ligament Registry (ACL controls). The matching variables were age, sex and BMI. Symptoms and functions measured by KOOS were compared.

Results

33 patients (10 men, 23 women) with mean age of 18.9 (SD=5.0) were included and matched with 66 ACL-controls. The KOOS subscores for the MPFL group were: Pain; 72.1, Symptoms; 68.3, ADL; 83.3, Sport; 51.4 and QoL; 37.5. The scores were significantly lower compared to the ACL controls for the first three of the five KOOS subscores (Differences: Pain; 8.6, p=0.021, Symptoms; 11.0, p=0.001, ADL; 7.0, p=0.009). For the last two subscores there was no significant difference between the groups. Articular cartilage injury was present in 36.4% in the MPFL group and 7.6% in the ACL group (p<0.001). The median duration of symptoms from injury to operation was 32.5 months (range: 18.3-78.5) for the MPFL-group and 6.5 months (range: 4.0-15.0) for the ACL controls (p<0.001).

Conclusions

and clinical relevance: Patients with recurrent patella dislocations experience symptoms and function at the same level or inferior to the ACL injured scheduled for surgery. The patients with recurrent patella instability need an effective treatment as exists for the ACL injured knee.
Level of evidence: Level II, case-control study.