Detaillierte Beitrags-Information
| Beitragstitel | Recurrent Patellar Dislocations: Trochleoplasty Improves the Results of Medial Patellofemoral Ligament Surgery only in Severe Trochlear Dysplasia – A Meta-analysis |
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| Beitragscode | P059 |
| Autoren | |
| Präsentationsform | Poster |
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| Abstract |
Introduction Medial patellofemoral ligament (MPFL) surgery combined with trochleoplasty (TP) is often performed to restore the normal patellofemoral biomechanics avoiding recurrent lateral patellar dislocation (LPD) in patients with trochlear dysplasia (TD). However, TP is and invasive and technically demanding procedure and the advantages of combining a TP to MPFL surgery instead of performing MPFL surgery without TP are still controversial. Methods This meta-analysis quantitatively synthesizes and compares data about outcomes of the treatment of recurrent LPD with MPFL surgery without or with TP in patients affected by TD. A systematic literature search about the treatment of recurrent LPD in the presence of TD was conducted. The primary outcome was the redislocation rate, analysed for different type of TD. As secondary outcome Kujala, and IKDC score were analysed through a meta-analysis. Furthermore, the complication rate was analysed. Results No significant difference was found in the overall redislocation rate between MPFL surgery without and with TP. The redislocation rate after MPFL surgery without TP in patients with type A or B TD and in patients with type C or D TD was significantly different (2.7% vs. 18.6%; p < 0.001). In the analysis for every single type of TD the following results were obtained: a redislocation rate of 1.8% in type A, 3.2% in type B, 11.9% in type C, and 7.4% in type D TD. A significant difference in the complication rate favoring MPFL surgery without TP was documented. Both surgical approaches provided a significant improvement with no difference in Kujala and IKDC scores. These results were confirmed when data were analysed including only patients with type B, C, or D TD or without additional bone remodelling procedures . Conclusion Isolated MPFL is as effective as combined TP and MPFL surgery in preventing redislocation and improving clinical and functional outcomes in patients with recurrent LPD and knees affected by moderate TD. However, in case of severe TD, the redislocation rate is lower when TP is performed in combination with MPFL surgery, although with comparable clinical outcomes and a higher risk of postoperative range of motion (ROM) limitation. |