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Medicina dello Sport 2022 June;75(2):248-62

DOI: 10.23736/S0025-7826.22.04067-4


language: English, Italian

Effectiveness of anatomical medial patellofemoral ligament reconstruction in mid-adolescent athletes with recurrent patellar dislocation and their return to sports

Erkan AKGUN 1, Ahmet O. AKPOLAT 2 , Ismail B. ATALAY 3, Demet PEPELE KURDAL 2, Tolga TOLUNAY 4

1 Department of Orthopedics Surgery and Traumatology, Pursaklar Government Hospital, Ankara, Turkey; 2 Department of Orthopedics Surgery and Traumatology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Science, Istanbul, Turkey; 3 Ankara Oncology Training and Research Hospital, Orthopedics Surgery and Traumatology Department, Ankara, Turkey; 4 Department of Orthopedics Surgery and Traumatology, Faculty of Medicine, Gazi University, Ankara, Turkey


BACKGROUND: This study aimed to investigate the effectiveness of anatomical medial patellofemoral ligament (MPFL) reconstruction in allowing athletes aged 15 to 18 years to return to sports using applicable indicators.
METHODS: Anatomical MPFL reconstruction was performed on a total of 14 knees of 13 mid-adolescent athletes (five males, eight females; mean age 16.4 years; range 15-18 years) diagnosed with recurrent patellar dislocation. A semitendinosus autograft was used in all patients and tunnel-bridge-tunnel method was preferred without using fixation material in patellar fixation, whereas bioscrew fixation was preferred in femoral fixation. Cases that underwent an à la carte procedure were not included in this study. The patients were followed up for a mean period of 5.5 years (range 47-96 months). Preoperative and postoperative clinical and functional evaluations of the patients were performed using the Lysholm Knee Scoring System and the Kujala Anterior Knee Pain Scale, whereas the patients’ ability to return to sports was evaluated using the Tegner Activity Scale.
RESULTS: The mean preoperative Lysholm knee scores were 51.2±9.3 (range 38-66), whereas they were 93.1±5.6 (range 77-100) postoperatively (P<0.01). The mean preoperative Kujala anterior knee pain scores were 56±10 (range 38-72), whereas the postoperative mean scores were 93.8±7.5 (range 70-100) (P<0.01). Further, although the preoperative mean Tegner activity scores were 3.5±1.45 (range 1-6), the postoperative mean scores were 7.07±1.7 (range 3-9) (P<0.01). According to the Tegner activity scores, nine patients were able to return to their sports activities during the postoperative period. Although three patients do not currently participate in sports professionally, they engage in recreational sports activities 3 days a week. Further, one patient was unable to return to sports.
CONCLUSIONS: Recurrent patellar dislocation continues to be an important problem in mid-adolescent athletes. We concluded that anatomical MPFL reconstruction is an effective treatment for cases with the appropriate indication in this age range.

KEY WORDS: Patella; Joint instability; Patellofemoral joint; Reconstructive surgical procedures; Adolescent; Athletes

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