Medial patellofemoral ligament reconstruction using nonresorbable sutures yields comparable outcomes to reconstruction with a pedicled quadriceps tendon autograft when performed in addition to bony risk factor correction
Purpose To evaluate the results for reconstruction of the medial patellofemoral ligament using synthetic nonresorbable sutures (S-MPFL-R) in comparison to MPFL-R using quadriceps tendon autograft (QT-MPFL-R) in patients undergoing simultaneous correction of anatomic risk factors for lateral patellar...
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Published in | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 31; no. 1; pp. 264 - 271 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.01.2023
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Abstract | Purpose
To evaluate the results for reconstruction of the medial patellofemoral ligament using synthetic nonresorbable sutures (S-MPFL-R) in comparison to MPFL-R using quadriceps tendon autograft (QT-MPFL-R) in patients undergoing simultaneous correction of anatomic risk factors for lateral patellar instability (LPI) at a minimum of 2 years of follow-up.
Methods
Between November 2018 and June 2019, 19 patients (male/female 8/11; mean age 26 ± 7 years) underwent S-MPFL-R (FiberTape
®
) in combination with the correction of predisposing risk factors for LPI. The control group of 38 patients (male/female 16/22, mean age 26 ± 6 years) who underwent QT-MPFL-R was matched 1:2 by sex, age, anatomic risk factors, and concomitant surgical correction of bony risk factors. The Banff Patella Instability Instrument 2.0 (BPII 2.0) and a numerical analog scale (NAS 0–10) for patellofemoral pain and subjective knee joint function were used to assess patients’ reported quality of life before and after surgery.
Results
The BPII 2.0 score increased from 35.0 ± 21.7 points to 79.7 ± 13.3 points (
p
< 0.0001) in the S-MPRL-R group and from 44.3 ± 19.6 points to 80.9 ± 15 points (
p
< 0.0001) in the QT-MPFL-R group from preoperatively to postoperatively, respectively, without any significant difference between the groups. In the S-MPFL-R group and QT-MPFL-R group, 95% (18/19) and 92% (35/38) of patients, respectively, crossed the minimally clinically important difference reported for the BPII 2.0. NAS values for pain and subjective knee joint function improved significantly in both groups (
p
< 0.0001,
p
< 0.0001) without any significant difference between the groups at the final follow-up.
Conclusions
This study demonstrates that nonresorbable sutures can serve as a viable option for MPFL-R, yielding comparable outcomes compared to quadriceps tendon autograft reconstruction when performed concomitantly with the correction of anatomic risk factors for LPI. This option reduces the need for autologous tendon harvesting or the use of allografts for MPFL-R.
Level of evidence
Level III. |
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AbstractList | To evaluate the results for reconstruction of the medial patellofemoral ligament using synthetic nonresorbable sutures (S-MPFL-R) in comparison to MPFL-R using quadriceps tendon autograft (QT-MPFL-R) in patients undergoing simultaneous correction of anatomic risk factors for lateral patellar instability (LPI) at a minimum of 2 years of follow-up.
Between November 2018 and June 2019, 19 patients (male/female 8/11; mean age 26 ± 7 years) underwent S-MPFL-R (FiberTape
) in combination with the correction of predisposing risk factors for LPI. The control group of 38 patients (male/female 16/22, mean age 26 ± 6 years) who underwent QT-MPFL-R was matched 1:2 by sex, age, anatomic risk factors, and concomitant surgical correction of bony risk factors. The Banff Patella Instability Instrument 2.0 (BPII 2.0) and a numerical analog scale (NAS 0-10) for patellofemoral pain and subjective knee joint function were used to assess patients' reported quality of life before and after surgery.
The BPII 2.0 score increased from 35.0 ± 21.7 points to 79.7 ± 13.3 points (p < 0.0001) in the S-MPRL-R group and from 44.3 ± 19.6 points to 80.9 ± 15 points (p < 0.0001) in the QT-MPFL-R group from preoperatively to postoperatively, respectively, without any significant difference between the groups. In the S-MPFL-R group and QT-MPFL-R group, 95% (18/19) and 92% (35/38) of patients, respectively, crossed the minimally clinically important difference reported for the BPII 2.0. NAS values for pain and subjective knee joint function improved significantly in both groups (p < 0.0001, p < 0.0001) without any significant difference between the groups at the final follow-up.
This study demonstrates that nonresorbable sutures can serve as a viable option for MPFL-R, yielding comparable outcomes compared to quadriceps tendon autograft reconstruction when performed concomitantly with the correction of anatomic risk factors for LPI. This option reduces the need for autologous tendon harvesting or the use of allografts for MPFL-R.
Level III. PURPOSETo evaluate the results for reconstruction of the medial patellofemoral ligament using synthetic nonresorbable sutures (S-MPFL-R) in comparison to MPFL-R using quadriceps tendon autograft (QT-MPFL-R) in patients undergoing simultaneous correction of anatomic risk factors for lateral patellar instability (LPI) at a minimum of 2 years of follow-up. METHODSBetween November 2018 and June 2019, 19 patients (male/female 8/11; mean age 26 ± 7 years) underwent S-MPFL-R (FiberTape®) in combination with the correction of predisposing risk factors for LPI. The control group of 38 patients (male/female 16/22, mean age 26 ± 6 years) who underwent QT-MPFL-R was matched 1:2 by sex, age, anatomic risk factors, and concomitant surgical correction of bony risk factors. The Banff Patella Instability Instrument 2.0 (BPII 2.0) and a numerical analog scale (NAS 0-10) for patellofemoral pain and subjective knee joint function were used to assess patients' reported quality of life before and after surgery. RESULTSThe BPII 2.0 score increased from 35.0 ± 21.7 points to 79.7 ± 13.3 points (p < 0.0001) in the S-MPRL-R group and from 44.3 ± 19.6 points to 80.9 ± 15 points (p < 0.0001) in the QT-MPFL-R group from preoperatively to postoperatively, respectively, without any significant difference between the groups. In the S-MPFL-R group and QT-MPFL-R group, 95% (18/19) and 92% (35/38) of patients, respectively, crossed the minimally clinically important difference reported for the BPII 2.0. NAS values for pain and subjective knee joint function improved significantly in both groups (p < 0.0001, p < 0.0001) without any significant difference between the groups at the final follow-up. CONCLUSIONSThis study demonstrates that nonresorbable sutures can serve as a viable option for MPFL-R, yielding comparable outcomes compared to quadriceps tendon autograft reconstruction when performed concomitantly with the correction of anatomic risk factors for LPI. This option reduces the need for autologous tendon harvesting or the use of allografts for MPFL-R. LEVEL OF EVIDENCELevel III. Abstract Purpose To evaluate the results for reconstruction of the medial patellofemoral ligament using synthetic nonresorbable sutures (S-MPFL-R) in comparison to MPFL-R using quadriceps tendon autograft (QT-MPFL-R) in patients undergoing simultaneous correction of anatomic risk factors for lateral patellar instability (LPI) at a minimum of 2 years of follow-up. Methods Between November 2018 and June 2019, 19 patients (male/female 8/11; mean age 26 ± 7 years) underwent S-MPFL-R (FiberTape ® ) in combination with the correction of predisposing risk factors for LPI. The control group of 38 patients (male/female 16/22, mean age 26 ± 6 years) who underwent QT-MPFL-R was matched 1:2 by sex, age, anatomic risk factors, and concomitant surgical correction of bony risk factors. The Banff Patella Instability Instrument 2.0 (BPII 2.0) and a numerical analog scale (NAS 0–10) for patellofemoral pain and subjective knee joint function were used to assess patients’ reported quality of life before and after surgery. Results The BPII 2.0 score increased from 35.0 ± 21.7 points to 79.7 ± 13.3 points ( p < 0.0001) in the S-MPRL-R group and from 44.3 ± 19.6 points to 80.9 ± 15 points ( p < 0.0001) in the QT-MPFL-R group from preoperatively to postoperatively, respectively, without any significant difference between the groups. In the S-MPFL-R group and QT-MPFL-R group, 95% (18/19) and 92% (35/38) of patients, respectively, crossed the minimally clinically important difference reported for the BPII 2.0. NAS values for pain and subjective knee joint function improved significantly in both groups ( p < 0.0001, p < 0.0001) without any significant difference between the groups at the final follow-up. Conclusions This study demonstrates that nonresorbable sutures can serve as a viable option for MPFL-R, yielding comparable outcomes compared to quadriceps tendon autograft reconstruction when performed concomitantly with the correction of anatomic risk factors for LPI. This option reduces the need for autologous tendon harvesting or the use of allografts for MPFL-R. Level of evidence Level III. Purpose To evaluate the results for reconstruction of the medial patellofemoral ligament using synthetic nonresorbable sutures (S-MPFL-R) in comparison to MPFL-R using quadriceps tendon autograft (QT-MPFL-R) in patients undergoing simultaneous correction of anatomic risk factors for lateral patellar instability (LPI) at a minimum of 2 years of follow-up. Methods Between November 2018 and June 2019, 19 patients (male/female 8/11; mean age 26 ± 7 years) underwent S-MPFL-R (FiberTape ® ) in combination with the correction of predisposing risk factors for LPI. The control group of 38 patients (male/female 16/22, mean age 26 ± 6 years) who underwent QT-MPFL-R was matched 1:2 by sex, age, anatomic risk factors, and concomitant surgical correction of bony risk factors. The Banff Patella Instability Instrument 2.0 (BPII 2.0) and a numerical analog scale (NAS 0–10) for patellofemoral pain and subjective knee joint function were used to assess patients’ reported quality of life before and after surgery. Results The BPII 2.0 score increased from 35.0 ± 21.7 points to 79.7 ± 13.3 points ( p < 0.0001) in the S-MPRL-R group and from 44.3 ± 19.6 points to 80.9 ± 15 points ( p < 0.0001) in the QT-MPFL-R group from preoperatively to postoperatively, respectively, without any significant difference between the groups. In the S-MPFL-R group and QT-MPFL-R group, 95% (18/19) and 92% (35/38) of patients, respectively, crossed the minimally clinically important difference reported for the BPII 2.0. NAS values for pain and subjective knee joint function improved significantly in both groups ( p < 0.0001, p < 0.0001) without any significant difference between the groups at the final follow-up. Conclusions This study demonstrates that nonresorbable sutures can serve as a viable option for MPFL-R, yielding comparable outcomes compared to quadriceps tendon autograft reconstruction when performed concomitantly with the correction of anatomic risk factors for LPI. This option reduces the need for autologous tendon harvesting or the use of allografts for MPFL-R. Level of evidence Level III. |
Author | Zimmermann, Felix Balcarek, Peter Milinkovic, Danko Dan |
Author_xml | – sequence: 1 givenname: Danko Dan orcidid: 0000-0002-0672-2640 surname: Milinkovic fullname: Milinkovic, Danko Dan email: danko.milinkovic@gmail.com organization: Center for Musculoskeletal Surgery, Charité-University Medicine Berlin – sequence: 2 givenname: Felix surname: Zimmermann fullname: Zimmermann, Felix organization: Berufsgenossenschaftliche Unfallklinik Ludwigshafen – sequence: 3 givenname: Peter surname: Balcarek fullname: Balcarek, Peter organization: Arcus Sportklinik, Department of Trauma Surgery, Orthopaedics, and Plastic Surgery, University Medicine Göttingen |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35972519$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1007_s43205_023_00255_2 crossref_primary_10_1007_s00167_022_07256_0 crossref_primary_10_3390_medsci11040075 crossref_primary_10_1007_s00142_023_00627_w crossref_primary_10_1016_j_otsm_2023_151022 crossref_primary_10_1016_j_otsm_2023_151033 |
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Keywords | Synthetic graft Autograft MPFL reconstruction Risk factors Bony correction BPII 2.0 |
Language | English |
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PublicationTitle | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
PublicationTitleAbbrev | Knee Surg Sports Traumatol Arthrosc |
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Publisher | Springer Berlin Heidelberg Springer Nature B.V |
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To evaluate the results for reconstruction of the medial patellofemoral ligament using synthetic nonresorbable sutures (S-MPFL-R) in comparison to... To evaluate the results for reconstruction of the medial patellofemoral ligament using synthetic nonresorbable sutures (S-MPFL-R) in comparison to MPFL-R using... Abstract Purpose To evaluate the results for reconstruction of the medial patellofemoral ligament using synthetic nonresorbable sutures (S-MPFL-R) in... PurposeTo evaluate the results for reconstruction of the medial patellofemoral ligament using synthetic nonresorbable sutures (S-MPFL-R) in comparison to... PURPOSETo evaluate the results for reconstruction of the medial patellofemoral ligament using synthetic nonresorbable sutures (S-MPFL-R) in comparison to... |
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SubjectTerms | Adult Age Allografts Autografts Female Females Humans Joint Instability - etiology Joint Instability - surgery Joints (anatomy) Knee Knee Joint Lateral stability Ligaments Ligaments, Articular - surgery Male Males Medicine Medicine & Public Health Orthopedics Pain Patellar Dislocation - surgery Patellofemoral Joint - surgery Quadriceps muscle Quality assessment Quality of Life Reconstructive surgery Risk analysis Risk Factors Sports Medicine Sutures Tendons Tendons - transplantation Young Adult |
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Title | Medial patellofemoral ligament reconstruction using nonresorbable sutures yields comparable outcomes to reconstruction with a pedicled quadriceps tendon autograft when performed in addition to bony risk factor correction |
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