MPFL reconstruction is preferred for pediatric patellar dislocations with a loose body

Source / Disclosures Published by:

Source:

Edmonds EW, et al. Paper 128. Presented at: Pediatric Orthopedic Society of North America Annual Meeting; May 12-15, 2021; Dallas (hybrid gathering).

Disclosures:
Edmonds does not report relevant financial information.

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Medial patellofemoral ligament reconstruction increased stability in adolescent patients with acute first-time patellar dislocation and an associated chondral or osteochondral loose body, according to the results presented.

“If you have a loose body, especially if it’s larger than an inch, then you probably need surgery to remove or repair it,” Eric W. Edmonds, MD, said an orthopedic researcher and sports medicine specialist at Rady Children’s Hospital in San Diego in his presentation at the annual meeting of the Pediatric Orthopedic Society of North America. “The question becomes, what are you doing with the MPFL?”

Edmonds and colleagues analyzed 76 adolescent patients (mean age 14 years) with a first patellar dislocation and an associated chondral or osteochondral loose body. Researchers performed a prospective analysis of 30 patients undergoing MPFL reconstruction and compared the results with a retrospective analysis of 46 patients undergoing MPFL repair or no intervention. According to the study summary, outcome measures included recurrent subluxation or dislocation, Kujala score, SANE score, patient satisfaction, and return to sports.

Eric W. Edmonds

Edmonds and colleagues found no significant differences in patient reported outcomes (PROs); however, they found that compared to the recovery or no treatment cohort, the reconstruction cohort had fewer cases of recurrent instability (10% vs. 58.7%), fewer secondary procedures (6.7% vs. 47.8%), and more patients returned to sports.

“Ultimately, you can [MPFL] reconstruction and improvement [the recurrent instability rate] by fivefold – just by doing the reconstruction at that point, ”said Edmonds. “By doing that, you don’t change their PROs.”

“In conclusion, we would recommend performing MPFL reconstruction in the setting of those first dislocators with an osteochondral fragment versus a ‘do nothing or fix’ of that ligament,” he added.

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Patellofemoral Update

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