Key points are not available for this paper at this time.
BACKGROUND: Patellar instability has the highest incidence in adolescents aged between 14 and 18 years. The unique relationship between the medial patellofemoral ligament (MPFL) and the distal femoral physis in skeletally immature patients warrants precisely positioned MPFL graft insertion. A paucity of data are available evaluating the results of MPFL reconstruction using allograft tendon before skeletal maturity. PURPOSES: (1) To assess the results of MPFL reconstruction using allograft tendon in skeletally immature patients by analyzing redislocation and reoperation rates, radiological outcomes, and patient-reported outcomes and (2) to determine whether epidemiological, intraoperative, or radiographic factors influence recurrent instability and clinical outcomes. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Prospectively collected data were retrospectively analyzed for 69 skeletally immature patients who experienced a first-time or recurrent lateral patellar dislocation and were treated with anatomic MPFL reconstruction. Inclusion criteria were MPFL reconstruction using allograft and the availability of preoperative magnetic resonance imaging scans in the presence of open or partially open physes. Patients with <2 years of follow-up and patients with previous surgeries on the same knee were excluded from the study. Preoperative radiographic imaging was reviewed and analyzed. Trochlear dysplasia, tibial tubercle-trochlear groove distance, and patellar height were evaluated. Descriptive data, concomitant injuries, surgical procedure details, complications, and postoperative history were assessed via review of medical records and patient charts. Validated patient-reported and surgeon-measured outcomes were collected pre- and postoperatively, including Kujala score, Lysholm score, and Tegner activity score. Return-to-sports rate was assessed. The influence of epidemiological, intraoperative, and radiographic parameters on the redislocation rates and clinical outcomes was assessed using a multiple linear regression model. RESULTS: = .32). CONCLUSION: Physeal-sparing anatomic reconstruction of the MPFL using an allograft tendon in skeletally immature patients was a safe and effective treatment for patellar instability, regardless of patellar height and trochlear dysplasia. Failure rates decreased when the MPFL reconstruction was performed concomitantly with a tibial tubercle osteotomy.
Husen et al. (Tue,) studied this question.