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Clinical outcome in MPFL reconstruction with and without tuberositas transposition

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Abstract
There are several surgical options for recurrent patella dislocations. As the reconstruction of the medial patellofemoral ligament (MPFL) has been proven to restore stability, it has become more accepted. Aim of this study was to investigate the clinical outcome after MPFL reconstruction as an isolated procedure or in association with a transposition of the tibial tubercle (in case of patella alta or an excessive TT-TG) in a large prospective cohort study. Additionally, the effect on patellar height was analysed radiographically using the Caton-Deschamps index. In a large prospective cohort study of 129 knees in 124 patients (81 females, 48 males, mean age 22.8 +/- 7.7 years), 91 knees received primary MPFL reconstruction (group 1) and 38 were a combination with a transposition of the tibial tubercle (group 2). The clinical follow-up was evaluated using KOOS and Kujala scores preoperatively and 1 year postoperatively. Patient satisfaction, complications and revision surgery were recorded. Overall, Kujala improved significantly from 53.5 (SD 22.7) preoperatively to 74.7 (SD 20.5) postoperatively (p < 0.01). All KOOS subdomains improved significantly (p < 0.01). No significant difference for Kujala score between groups was noticed. Revision rate was (5/129) 3.9 %. Reconstruction was supplemented with a transfer of the tibial tuberosity in (38/129) 29.4 % of the cases and shows a comparable outcome. MPFL reconstruction is a viable treatment option for episodic patellar dislocation. A concomitant tuberositas transposition is useful in selected patients.
Keywords
Medial patellofemoral ligament, MPFL, Patellar instability, Tibial tuberosity transfer, MEDIAL PATELLOFEMORAL LIGAMENT, LATERAL PATELLAR TRANSLATION, DISLOCATION, INSTABILITY, TENDON, COMPLICATIONS, AUTOGRAFT, FIXATION, KNEE

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Chicago
Mulliez, Alexander, Delphine Lambrecht, Dimitri Verbruggen, Catherine Van Der Straeten, Peter Verdonk, and Jan Victor. 2017. “Clinical Outcome in MPFL Reconstruction with and Without Tuberositas Transposition.” Knee Surgery Sports Traumatology Arthroscopy 25 (9): 2708–2714.
APA
Mulliez, A., Lambrecht, D., Verbruggen, D., Van Der Straeten, C., Verdonk, P., & Victor, J. (2017). Clinical outcome in MPFL reconstruction with and without tuberositas transposition. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 25(9), 2708–2714.
Vancouver
1.
Mulliez A, Lambrecht D, Verbruggen D, Van Der Straeten C, Verdonk P, Victor J. Clinical outcome in MPFL reconstruction with and without tuberositas transposition. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 2017;25(9):2708–14.
MLA
Mulliez, Alexander, Delphine Lambrecht, Dimitri Verbruggen, et al. “Clinical Outcome in MPFL Reconstruction with and Without Tuberositas Transposition.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 25.9 (2017): 2708–2714. Print.
@article{8028140,
  abstract     = {There are several surgical options for recurrent patella dislocations. As the reconstruction of the medial patellofemoral ligament (MPFL) has been proven to restore stability, it has become more accepted. Aim of this study was to investigate the clinical outcome after MPFL reconstruction as an isolated procedure or in association with a transposition of the tibial tubercle (in case of patella alta or an excessive TT-TG) in a large prospective cohort study. Additionally, the effect on patellar height was analysed radiographically using the Caton-Deschamps index. 
In a large prospective cohort study of 129 knees in 124 patients (81 females, 48 males, mean age 22.8 +/- 7.7 years), 91 knees received primary MPFL reconstruction (group 1) and 38 were a combination with a transposition of the tibial tubercle (group 2). The clinical follow-up was evaluated using KOOS and Kujala scores preoperatively and 1 year postoperatively. Patient satisfaction, complications and revision surgery were recorded. 
Overall, Kujala improved significantly from 53.5 (SD 22.7) preoperatively to 74.7 (SD 20.5) postoperatively (p {\textlangle} 0.01). All KOOS subdomains improved significantly (p {\textlangle} 0.01). No significant difference for Kujala score between groups was noticed. Revision rate was (5/129) 3.9 \%. Reconstruction was supplemented with a transfer of the tibial tuberosity in (38/129) 29.4 \% of the cases and shows a comparable outcome. 
MPFL reconstruction is a viable treatment option for episodic patellar dislocation. A concomitant tuberositas transposition is useful in selected patients.},
  author       = {Mulliez, Alexander and Lambrecht, Delphine and Verbruggen, Dimitri and Van Der Straeten, Catherine and Verdonk, Peter and Victor, Jan},
  issn         = {0942-2056},
  journal      = {KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY},
  keyword      = {Medial patellofemoral ligament,MPFL,Patellar instability,Tibial tuberosity transfer,MEDIAL PATELLOFEMORAL LIGAMENT,LATERAL PATELLAR TRANSLATION,DISLOCATION,INSTABILITY,TENDON,COMPLICATIONS,AUTOGRAFT,FIXATION,KNEE},
  language     = {eng},
  number       = {9},
  pages        = {2708--2714},
  title        = {Clinical outcome in MPFL reconstruction with and without tuberositas transposition},
  url          = {http://dx.doi.org/10.1007/s00167-015-3654-0},
  volume       = {25},
  year         = {2017},
}

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