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FEMORAL TUNNEL FIXATION FOR MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION IN THE GROWING PATIENT IS SAFE FOR FUTURE GROWTH

BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction has been shown to be a successful treatment for patients with recurrent patellar instability and is increasingly used to treat skeletally immature patients. PURPOSE: The purpose of this study is to compare radiographic parameters prior...

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Autores principales: Gross, Bruno, Sabatino, Meagan J., Brenner, Madison, Wyatt, Charles W., Wilson, Philip, Ellis, Henry
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238817/
http://dx.doi.org/10.1177/2325967120S00256
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author Gross, Bruno
Sabatino, Meagan J.
Brenner, Madison
Wyatt, Charles W.
Wilson, Philip
Ellis, Henry
author_facet Gross, Bruno
Sabatino, Meagan J.
Brenner, Madison
Wyatt, Charles W.
Wilson, Philip
Ellis, Henry
author_sort Gross, Bruno
collection PubMed
description BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction has been shown to be a successful treatment for patients with recurrent patellar instability and is increasingly used to treat skeletally immature patients. PURPOSE: The purpose of this study is to compare radiographic parameters prior to and following an MPFL reconstruction with femoral tunnel fixation in the skeletally immature patient to investigate potential effects on the physis and future growth. METHODS: Skeletally immature patients undergoing isolated MPFL reconstruction were retrospectively reviewed. Fixation of proximal MPFL was performed as a femoral socket using Schottle’s point with the entry approximately 5 mm distal to the physis (Figure 1). Patients with open growth plates and 1-year post-operative standing alignments were included. Radiographic measures of patellar tilt, patellar height, patellar subluxation, and trochlear dysplasia were compared pre-operatively and post-operatively on the operative limb. Pre- and post-operative coronal alignment and limb length measurements were compared between the operative and non-operative limbs. RESULTS: Nineteen skeletally immature patients with an average age of 11.6 years (range 5-15) underwent isolated MPFL reconstruction. The average follow-up time was 24 months. No significant differences were found between the change in femur (0.49 mm, p=0.526) or total limb length (1.08 mm, p=0.241) when comparing the operative to the non-operative limb, with an average of 47 mm of growth in the operative limb seen during the time period. There was no significant difference in the change in LDFA between operative and non-operative limb as well as symmetric changes noted in the mechanical axis. The change in patellar tilt on the operative limb was found to be significant (12.78°, p=0.030), and the change in patellar height by Caton-Deschamps approached significance (0.08mm, p= 0.077). No significant difference was found with trochlear dysplasia measures. CONCLUSION: The present study suggests MPFL reconstruction with femoral tunnel fixation is safe and does not result in growth disturbance in skeletally immature patients.
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spelling pubmed-72388172020-06-01 FEMORAL TUNNEL FIXATION FOR MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION IN THE GROWING PATIENT IS SAFE FOR FUTURE GROWTH Gross, Bruno Sabatino, Meagan J. Brenner, Madison Wyatt, Charles W. Wilson, Philip Ellis, Henry Orthop J Sports Med Article BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction has been shown to be a successful treatment for patients with recurrent patellar instability and is increasingly used to treat skeletally immature patients. PURPOSE: The purpose of this study is to compare radiographic parameters prior to and following an MPFL reconstruction with femoral tunnel fixation in the skeletally immature patient to investigate potential effects on the physis and future growth. METHODS: Skeletally immature patients undergoing isolated MPFL reconstruction were retrospectively reviewed. Fixation of proximal MPFL was performed as a femoral socket using Schottle’s point with the entry approximately 5 mm distal to the physis (Figure 1). Patients with open growth plates and 1-year post-operative standing alignments were included. Radiographic measures of patellar tilt, patellar height, patellar subluxation, and trochlear dysplasia were compared pre-operatively and post-operatively on the operative limb. Pre- and post-operative coronal alignment and limb length measurements were compared between the operative and non-operative limbs. RESULTS: Nineteen skeletally immature patients with an average age of 11.6 years (range 5-15) underwent isolated MPFL reconstruction. The average follow-up time was 24 months. No significant differences were found between the change in femur (0.49 mm, p=0.526) or total limb length (1.08 mm, p=0.241) when comparing the operative to the non-operative limb, with an average of 47 mm of growth in the operative limb seen during the time period. There was no significant difference in the change in LDFA between operative and non-operative limb as well as symmetric changes noted in the mechanical axis. The change in patellar tilt on the operative limb was found to be significant (12.78°, p=0.030), and the change in patellar height by Caton-Deschamps approached significance (0.08mm, p= 0.077). No significant difference was found with trochlear dysplasia measures. CONCLUSION: The present study suggests MPFL reconstruction with femoral tunnel fixation is safe and does not result in growth disturbance in skeletally immature patients. SAGE Publications 2020-04-30 /pmc/articles/PMC7238817/ http://dx.doi.org/10.1177/2325967120S00256 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc-nd/4.0/ This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For article reuse guidelines, please visit SAGE’s website at http://www.sagepub.com/journals-permissions.
spellingShingle Article
Gross, Bruno
Sabatino, Meagan J.
Brenner, Madison
Wyatt, Charles W.
Wilson, Philip
Ellis, Henry
FEMORAL TUNNEL FIXATION FOR MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION IN THE GROWING PATIENT IS SAFE FOR FUTURE GROWTH
title FEMORAL TUNNEL FIXATION FOR MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION IN THE GROWING PATIENT IS SAFE FOR FUTURE GROWTH
title_full FEMORAL TUNNEL FIXATION FOR MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION IN THE GROWING PATIENT IS SAFE FOR FUTURE GROWTH
title_fullStr FEMORAL TUNNEL FIXATION FOR MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION IN THE GROWING PATIENT IS SAFE FOR FUTURE GROWTH
title_full_unstemmed FEMORAL TUNNEL FIXATION FOR MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION IN THE GROWING PATIENT IS SAFE FOR FUTURE GROWTH
title_short FEMORAL TUNNEL FIXATION FOR MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION IN THE GROWING PATIENT IS SAFE FOR FUTURE GROWTH
title_sort femoral tunnel fixation for medial patellofemoral ligament reconstruction in the growing patient is safe for future growth
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238817/
http://dx.doi.org/10.1177/2325967120S00256
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