Clinical outcomes of medial patellofemoral ligament reconstruction in patients with an increased tibial tuberosity-trochlear groove distance.

PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction is performed to treat recurrent patellar dislocation (RPD). However, the effectiveness of MPFL reconstruction in patients with a severely lateralised tibial tuberosity remains unknown. In this study, the clinical outcomes of MPFL reconstruction in patients with an increased tibial tuberosity-trochlear groove (TT-TG) distance were examined.

METHODS

A total of thirty-four patients who underwent MPFL reconstruction for RPD were retrospectively examined. Nineteen patients with a TT-TG distance of >20 mm (increased TT-TG distance group) were compared with 15 patients with a TT-TG distance of <20 mm (control group). Clinical outcomes of MPFL reconstruction were evaluated by occurrence of re-dislocation, Crosby and Insall grading system, apprehension sign, and Kujala and Lysholm scores.

RESULTS

None of the patients reported re-dislocation. Apprehension sign remained in three patients in the increased TT-TG distance group and in one patient in the control group. According to the Crosby and Insall grading system, 9 patients (47%) were excellent, 9 (47%) were good, and 1 (5%) was fair to poor in the increased TT-TG distance group, while 6 (40%) were excellent and 9 (60%) were good in the control group. Kujala and Lysholm scores were significantly improved post-operatively in both groups. No significant correlations were observed between TT-TG distance and post-operative Kujala or Lysholm score.

CONCLUSION

Overall clinical outcomes of MPFL reconstruction were favourable even in patients with an increased TT-TG distance. TT-TG distance of >20 mm may not be an absolute indication for medialisation of the tibial tuberosity when performing MPFL reconstruction.

LEVEL OF EVIDENCE: Case-control study, Level III.