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Long-term outcomes after combined arthroscopic medial reefing and lateral release in patients with recurrent patellar instability – a retrospective analysis
BACKGROUND: There is currently no consensus regarding the optimal surgical treatment method for patients with recurrent patella instability. Our goal was to evaluate the long-term results of combined arthroscopic medial reefing and lateral release, to identify possible risk factors for recurrent dis...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483275/ https://www.ncbi.nlm.nih.gov/pubmed/28646869 http://dx.doi.org/10.1186/s12891-017-1636-8 |
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author | Schorn, Dominik Yang-Strathoff, Sera Gosheger, Georg Vogler, Tim Klingebiel, Sebastian Rickert, Carolin Andreou, Dimosthenis Liem, Dennis |
author_facet | Schorn, Dominik Yang-Strathoff, Sera Gosheger, Georg Vogler, Tim Klingebiel, Sebastian Rickert, Carolin Andreou, Dimosthenis Liem, Dennis |
author_sort | Schorn, Dominik |
collection | PubMed |
description | BACKGROUND: There is currently no consensus regarding the optimal surgical treatment method for patients with recurrent patella instability. Our goal was to evaluate the long-term results of combined arthroscopic medial reefing and lateral release, to identify possible risk factors for recurrent dislocations and residual complaints after surgical treatment and to assess functional outcome. METHODS: We performed a retrospective study of 38 patients (43 knees) treated with all-inside technique between 2001 and 2010. The functional outcome was evaluated with the Kujala score, while pain intensity was scored on a visual analogue scale (VAS). Contingency tables were analysed with Fisher’s exact test. Non-parametric analyses were carried out with the Mann-Whitney U and the Wilcoxon signed-rank test. Survival curves were calculated with the Kaplan-Meier method and compared with the log-rank test. RESULTS: The median age at surgery was 16 years (range, 9–44 years) and the median follow-up amounted to 9.7 years (range, 4.7–14.7 years). Residual complaints were present in 34 cases (79%). Patients with residual complaints had a trend for a higher body mass index (BMI) at surgery (25.7 vs. 21.6, P = .086). Twenty-two cases had recurrent dislocation after a median interval of 30 months. The probability of recurrent dislocations amounted to 16% after 1 year and 52% after 10 years. There were no significant differences in the presence of residual complaints (P = .721) and median VAS score (P = .313) between patients with or without recurrent dislocation. Patients with recurrent dislocations had a trend towards younger age at surgery (15 vs. 18 years, P = .076). The median Kujala score of the affected knee was 81. Patients with recurrent dislocations had a significantly lower score compared to patients without recurrent dislocations (67 vs. 91, P < .001). CONCLUSIONS: The combined arthroscopic lateral release with medial reefing does not appear to be an adequate treatment for patients with chronic patellar instability in long-term follow-up. Younger patients might be at a higher risk for recurrent dislocations, while a higher BMI at surgery might be associated with residual complaints. |
format | Online Article Text |
id | pubmed-5483275 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-54832752017-06-26 Long-term outcomes after combined arthroscopic medial reefing and lateral release in patients with recurrent patellar instability – a retrospective analysis Schorn, Dominik Yang-Strathoff, Sera Gosheger, Georg Vogler, Tim Klingebiel, Sebastian Rickert, Carolin Andreou, Dimosthenis Liem, Dennis BMC Musculoskelet Disord Research Article BACKGROUND: There is currently no consensus regarding the optimal surgical treatment method for patients with recurrent patella instability. Our goal was to evaluate the long-term results of combined arthroscopic medial reefing and lateral release, to identify possible risk factors for recurrent dislocations and residual complaints after surgical treatment and to assess functional outcome. METHODS: We performed a retrospective study of 38 patients (43 knees) treated with all-inside technique between 2001 and 2010. The functional outcome was evaluated with the Kujala score, while pain intensity was scored on a visual analogue scale (VAS). Contingency tables were analysed with Fisher’s exact test. Non-parametric analyses were carried out with the Mann-Whitney U and the Wilcoxon signed-rank test. Survival curves were calculated with the Kaplan-Meier method and compared with the log-rank test. RESULTS: The median age at surgery was 16 years (range, 9–44 years) and the median follow-up amounted to 9.7 years (range, 4.7–14.7 years). Residual complaints were present in 34 cases (79%). Patients with residual complaints had a trend for a higher body mass index (BMI) at surgery (25.7 vs. 21.6, P = .086). Twenty-two cases had recurrent dislocation after a median interval of 30 months. The probability of recurrent dislocations amounted to 16% after 1 year and 52% after 10 years. There were no significant differences in the presence of residual complaints (P = .721) and median VAS score (P = .313) between patients with or without recurrent dislocation. Patients with recurrent dislocations had a trend towards younger age at surgery (15 vs. 18 years, P = .076). The median Kujala score of the affected knee was 81. Patients with recurrent dislocations had a significantly lower score compared to patients without recurrent dislocations (67 vs. 91, P < .001). CONCLUSIONS: The combined arthroscopic lateral release with medial reefing does not appear to be an adequate treatment for patients with chronic patellar instability in long-term follow-up. Younger patients might be at a higher risk for recurrent dislocations, while a higher BMI at surgery might be associated with residual complaints. BioMed Central 2017-06-24 /pmc/articles/PMC5483275/ /pubmed/28646869 http://dx.doi.org/10.1186/s12891-017-1636-8 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Schorn, Dominik Yang-Strathoff, Sera Gosheger, Georg Vogler, Tim Klingebiel, Sebastian Rickert, Carolin Andreou, Dimosthenis Liem, Dennis Long-term outcomes after combined arthroscopic medial reefing and lateral release in patients with recurrent patellar instability – a retrospective analysis |
title | Long-term outcomes after combined arthroscopic medial reefing and lateral release in patients with recurrent patellar instability – a retrospective analysis |
title_full | Long-term outcomes after combined arthroscopic medial reefing and lateral release in patients with recurrent patellar instability – a retrospective analysis |
title_fullStr | Long-term outcomes after combined arthroscopic medial reefing and lateral release in patients with recurrent patellar instability – a retrospective analysis |
title_full_unstemmed | Long-term outcomes after combined arthroscopic medial reefing and lateral release in patients with recurrent patellar instability – a retrospective analysis |
title_short | Long-term outcomes after combined arthroscopic medial reefing and lateral release in patients with recurrent patellar instability – a retrospective analysis |
title_sort | long-term outcomes after combined arthroscopic medial reefing and lateral release in patients with recurrent patellar instability – a retrospective analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483275/ https://www.ncbi.nlm.nih.gov/pubmed/28646869 http://dx.doi.org/10.1186/s12891-017-1636-8 |
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