Abstract:
PURPOSE:Reconstruction of the medial patellofemoral ligament (MPFL) has become a popular procedure for patients with patellofemoral instability. Nevertheless, complication rates of up to 26 % have been reported. This study presents the analysis of failure and clinical outcome of subsequent revision surgery in young patients following unsuccessful medial patellofemoral ligament reconstruction. METHODS:Nineteen consecutive patients with unsuccessful MPFL reconstruction underwent revision surgery. Pre-operative assessment included physical examination, radiographs and magnetic resonance imaging to assess the MPFL graft, trochlear dysplasia, tibial tubercle-trochlear groove (TT-TG) distance, patella alta and femoral tunnel positioning. Evaluation also included the detection of cartilage injuries as well as visual analog scale (VAS), knee function scores and patient satisfaction. Each complication was analysed and an appropriate revision procedure was performed according to the identified technical or untreated anatomical risk factor. RESULTS:The average age at the time of the index operation was 20.2 years (range, 16-27 years). The average age at the time of the primary MPFL reconstruction was 18.4 years (range, 15-25). Three main reasons for failure after MPFL reconstruction could be identified: failure to consider additional risk factors, intra-operative technical errors and inappropriate patient selection. In five patients severe trochlear dysplasia and in two patients concomitant excessive femoral anteversion as additional risk factors were detected. Seven patients experienced medial retinacular pain with limited flexion due to technical errors caused in three patients by anterior placement of the femoral tunnel and in four others by overtensioning of the MPFL graft. Four patients with patellofemoral pain were found to have ICRS grade III or IV cartilage injuries. The median postoperative Kujala scores improved from 57 (34 - 73) pre-operatively to 83 (49 - 94), the median knee function improved from 5 (range, 2 - 6) pre-operatively to 8 (range, 3 - 10). Median VAS scores improved from 4 (2 - 7) to 2 (0 - 5). A total of 78.9% of patients were satisfied or very satisfied, 15.8% were partially satisfied and one patient (5.3%) was not satisfied with the result after revision surgery. CONCLUSION:Failure to consider additional risk factors, technical intra-operative errors and inappropriate patient selection were identified as reasons for revision surgery after MPFL reconstruction. Identifying the potential causes of failure can help to treat and possibly prevent future complications.
journal_name
Int Orthopjournal_title
International orthopaedicsauthors
Nelitz M,Williams RS,Lippacher S,Reichel H,Dornacher Ddoi
10.1007/s00264-014-2437-4subject
Has Abstractpub_date
2014-11-01 00:00:00pages
2265-72issue
11eissn
0341-2695issn
1432-5195journal_volume
38pub_type
杂志文章abstract:PURPOSE:The longest follow-up dual mobility series from inventor Gilles Bousquet focussing on implant survival and the incidence of dislocation. METHODS:This was a retrospective study from 1985 to 1990, on 240 hips using a PF® modular femoral stem and a dual mobility Novae® tripodal socket (SERF). RESULTS:The 22-year...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-011-1289-4
更新日期:2012-03-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-011-1211-0
更新日期:2011-11-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2012-09-01 00:00:00
abstract:PURPOSE:The optimum treatment for periprosthetic fractures in the region of the distal femur is undefined. Although internal fixation for prostheses which are stable is commonly utilised, this can lead to very prolonged morbidity and failure of the fracture to unite. Where the prosthesis is either loose or infected, re...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-015-2969-2
更新日期:2015-10-01 00:00:00
abstract::Forty-five patients with Paget's disease were studied, of whom 25 had fissure fractures affecting the bones of the lower limb. Ten patients treated with salmon calcitonin showed no improvement in their fissure fractures despite reduction in bone turnover. Treatment was effective where bone deformity was improved by tr...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00267839
更新日期:1981-01-01 00:00:00
abstract::The incidence of the major complications of operation have been studied prospectively in 1,722 patients with a proximal femoral fracture treated by either insertion of a hemiarthroplasty, internal fixation with a Dynamic Hip Screw (DHS) or multiple parallel screws. Major complications occurred in 8.0%. A special surgi...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00192477
更新日期:1994-06-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2021-01-30 00:00:00
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journal_title:International orthopaedics
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更新日期:2011-11-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2011-02-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章,评审
doi:10.1007/BF00268047
更新日期:1989-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-02-01 00:00:00
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更新日期:2017-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00264-018-3942-7
更新日期:2018-12-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s002640050262
更新日期:1998-01-01 00:00:00
abstract:PURPOSE:The aims of this retrospective study were to firstly introduce three practical bulk bone graft techniques based on acetabular morphology for dysplasia and secondly evaluate the long-term durability of acetabular reconstruction using those techniques combined with cemented total hip arthroplasty (THA). METHODS:...
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doi:10.1007/s00264-015-3039-5
更新日期:2016-09-01 00:00:00
abstract::Chronic back pain often leads to permanent disability and-apart from significant human suffering-also creates immense economic costs. There have been numerous epidemiological studies focussing on the incidence and the course of chronic low back pain. Less attention has been paid to the impact of subjective perception ...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-010-1081-x
更新日期:2011-05-01 00:00:00
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journal_title:International orthopaedics
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doi:10.1007/s00264-013-1781-0
更新日期:2013-04-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00178347
更新日期:1995-01-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00268506
更新日期:1989-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2004-02-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章,评审
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更新日期:2020-09-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2020-09-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2018-09-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章,多中心研究
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更新日期:2018-09-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-010-0995-7
更新日期:2010-10-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2007-04-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2012-10-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-018-4015-7
更新日期:2018-12-01 00:00:00