International Orthopaedics

, Volume 42, Issue 6, pp 1357–1362 | Cite as

Medial patellofemoral ligament reconstruction in children: do osseous abnormalities matter?

  • Sebastien Pesenti
  • Matthieu Ollivier
  • Jean-Charles Escudier
  • Mathieu Cermolacce
  • Alexandre Baud
  • Franck Launay
  • Jean-Luc Jouve
  • Elie Choufani
Original Paper
  • 126 Downloads

Abstract

Purpose

Management of post-traumatic patellar instability in children with osseous abnormalities is challenging because of the presence of an open physis. The aim of our study was to compare the rate of recurrence after isolated reconstruction of the medial patellofemoral ligament (MPFL) in children with or without osseous abnormalities.

Methods

The medical records of 25 children (27 knees) with recurrent patellar dislocation were reviewed. Each child underwent an isolated reconstruction of the MPFL using a hamstring graft. At the last follow-up, a clinical and radiographic evaluation was performed, including assessment of functional outcomes based on the Kujala score. Patients were compared in terms of the occurrence of a pre-existing osseous abnormality.

Results

The mean age at the time of the surgery was 13.8 years. Eleven patients had trochlear dysplasia (40%), three had a patella alta (11%) and seven had an increased TT-TG (26%). The recurrence rate was 3.7% (one patient), after a mean follow-up of 41.1 months. Recurrence was not more frequent in patients with preoperative anatomical predisposing factors. The mean Kujala score was 95. The mean time to return to practicing sports was 7.1 months.

Conclusions

Isolated MPFL reconstruction is an effective option for the management of post-traumatic patellofemoral instability in skeletally immature patients. The results of this technique seem to be independent on either proximal or distal misalignments such as trochlear dysplasia, patella alta, or increased TT-TG.

Keywords

Medial patellofemoral ligament (MPFL) Isolated reconstruction Trochlear dysplasia Increased tibial tuberosity-trochlear groove (TT-TG) Patella alta 

Notes

Acknowledgments

SP received grants from the Société Française de Chirurgie Orthopédique et Traumatologie (SOFCOT) and from the Société Française de Chirurgie Orthopédique Pédiatrique (SOFOP) and from the Association pour le Développement de la Recherche Médicale (ADEREM).

Compliance with ethical standards

Conflict of interest

None of the authors declare any conflict of interest.

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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Paediatric Orthopaedics, Timone Children’s HospitalAix-Marseille UniversityMarseilleFrance
  2. 2.Paediatric Orthopaedics, Timone EnfantsMarseilleFrance

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