P. Debieux (Sao Paulo, BR)

Instituto Cohen

Presenter Of 1 Presentation

 Conference Calendar
Podium Presentation Joint Specific Cartilage Repair

23.1.6 - Anteromedial Tibial Tubercle Osteotomy improves results of MPFL reconstruction in patients with TT-TG distance of 17-20mm

Presentation Number
23.1.6
Presentation Topic
Joint Specific Cartilage Repair
Lecture Time
11:15 - 11:24
Session Name
23.1 - Joint Preservation 2
Session Type
Free Papers
Corresponding Author
Authors
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

To compare the mid-term clinical outcomes of the anteromedialization tibial tubercle osteotomy combined with the medial patellofemoral ligament reconstruction (TTO+MPFLR) versusthe medial patellofemoral ligament reconstruction alone (MPFLRa) for the treatment of recurrent patellar instability (RPI) in patients with TT-TG 17 to 20 mm.

Methods and Materials

From January 2008 to August 2013, patients with RPI and TT-TG 17-20mm were divided into two groups: TTO+MPFLR or MPFLRa. Subjects were evaluated for J sign classification (1 to 4+), patellar glide (1 to 4+), apprehension test, increased femoral anteversion, Caton index, trochlea dysplasia, TT-TG, Kujala, Lysholm, IKDC, and Tegner. Kujala improvement was the primary outcome.

Results

Forty-two patients were evaluated: 18 in the TTO+MPFLR and 24 in the MPFLRa groups. Mean follow-up: 40.86 months (range 24 to 60 months). Demographics between the groups were not different. Preoperatively, there was no statistically significant difference between groups regarding J sign classification, patellar glide, apprehension test, increased femoral anteversion, Caton index, trochlea dysplasia, TT-TG, Kujala, Lysholm, IKDC, and Tegner. Postoperative J sign classification mean results comparing TTO+MPFLR and MPFLRa, respectively: 1, 1.33, p=0.006. Improvement was significantly higher in the TTO+MPFLR group in all scores, except for Tegner. Kujala improvement: 30.27, 23.95, p=0.003, was also clinically significant favoring TTO+MPFLR. Lysholm improvement: 40.5, 36.2, p=0.02. IKDC improvement: 38.59, 31.6, p=0.002. There were no reported recurrent subluxations or dislocations in either group.

Conclusion

TTO+MPFLR resulted in better functional outcome scores and patellar kinematics compared to MPFLRa in the surgical treatment of RPI in patients with TT-TG distance of 17-20mm.

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