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Reconstruction of the Medial Patellofemoral Ligament: Clinical Outcomes and Return to Sports.
[trochlear dysplasia]
Recent
studies
have
shown
that
medial
patellofemoral
ligament
(
MPFL
)
reconstruction
using
a
standardized
technique
provides
significant
improvements
in
all
outcome
scoring
systems
,
with
low
complication
rates
and
good
patient
satisfaction
.
Although
numerous
studies
have
assessed
clinical
results
,
there
is
little
published
literature
investigating
return
to
sporting
activities
after
reconstruction
of
the
MPFL
.
To
demonstrate
postoperative
outcomes
and
the
return-
to
-sports
rate
a
minimum
of
2
years
after
isolated
MPFL
reconstruction
in
a
young
patient
cohort
.
Case
series
;
Level
of
evidence
,
4
.
Between
2007
and
2010
,
a
total
of
72
isolated
MPFL
reconstructions
(
in
68
patients
)
were
performed
for
recurrent
patellar
dislocation
.
Pre-
and
postoperative
knee
assessment
included
a
thorough
history
of
symptoms
and
a
clinical
examination
consisting
of
crepitus
,
range
of
motion
,
patellofemoral
pain
,
and
patellar
apprehension
.
Knee
function
was
assessed
using
the
Kujala
score
,
International
Knee
Documentation
Committee
score
,
Tegner
activity
score
,
visual
analog
scale
(
VAS
)
,
and
Activity
Rating
Scale
(
ARS
)
.
Of
patients
who
participated
in
sports
preoperatively
(
62
/
68
patients
)
,
100
%
returned
to
sports
after
MPFL
reconstruction
;
53
%
returned
at
equal
or
higher
levels
,
whereas
47
%
returned
at
lower
levels
.
Fifty
-
four
of
68
patients
(
79
.
4
%
)
rated
themselves
as
very
satisfied
or
satisfied
with
the
results
.
The
median
Kujala
score
improved
significantly
from
66
to
87
.
5
and
the
median
International
Knee
Documentation
Committee
score
from
60
to
79
.
8
.
The
median
VAS
for
pain
score
illustrated
significant
preoperative
to
postoperative
improvement
,
from
4
to
2
.
Conversely
,
patients
'
activity
levels
according
to
the
Tegner
activity
score
dropped
from
4
.
5
to
4
,
and
the
median
Activity
Rating
Scale
score
dropped
from
6
to
3
.
There
was
also
a
persistent
instability
rate
of
10
%
as
well
as
a
slight
loss
of
knee
flexion
in
24
of
72
knees
.
Reconstruction
of
the
MPFL
is
a
safe
and
effective
treatment
for
patellofemoral
instability
without
severe
trochlear
dysplasia
and
allows
most
patients
to
engage
in
regular
sports
activities
2
years
postoperatively
,
at
least
at
a
recreational
level
.
However
,
potential
complications
,
such
as
persistent
instability
,
pain
,
and
loss
of
flexion
,
must
be
considered
.
Diseases
Validation
Diseases presenting
"visual analog scale"
symptom
oral submucous fibrosis
thoracic outlet syndrome
trochlear dysplasia
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