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Medial patellofemoral ligament reconstruction for patellar instability in patients with hypermobility: a case control study.
[trochlear dysplasia]
Hypermobility
is
an
acknowledged
risk
factor
for
patellar
instability
.
In
this
case
control
study
the
influence
of
hypermobility
on
clinical
outcome
following
medial
patellofemoral
ligament
(
MPFL
)
reconstruction
for
patellar
instability
was
studied
.
A
total
of
25
patients
with
hypermobility
as
determined
by
the
Beighton
criteria
were
assessed
and
compared
with
a
control
group
of
50
patients
who
were
matched
for
age
,
gender
,
indication
for
surgery
and
degree
of
trochlear
dysplasia
.
The
patients
with
hypermobility
had
a
Beighton
Score
of
≥
6
;
the
control
patients
had
a
score
of
<
4
.
All
patients
underwent
MPFL
reconstruction
performed
using
semitendinosus
autograft
and
a
standardised
arthroscopically
controlled
technique
.
The
mean
age
of
the
patients
was
25
Â
years
(
17
to
49
)
and
the
mean
follow-up
was
15
months
(
6
to
30
)
.
Patients
with
hypermobility
had
a
significant
improvement
in
function
following
surgery
,
with
reasonable
rates
of
satisfaction
,
perceived
improvement
,
willingness
to
repeat
and
likelihood
of
recommendation
.
Functional
improvements
were
significantly
less
than
in
control
patients
(
p
<
0
.
01
)
.
Joint
hypermobility
is
not
a
contraindication
to
MPFL
reconstruction
although
caution
is
recommended
in
managing
the
expectations
of
patients
with
hypermobility
before
consideration
of
surgery
.
