Functional testing and return to sport following stabilization surgery for recurrent lateral patellar instability in competitive athletes
Purpose Medial patellofemoral ligament (MPFL) reconstruction and tibial tubercle osteotomy are commonly used to treat recurrent lateral patellar instability, yet there are limited available data on return to sport (RTS) following these procedures. The purpose of this study is to evaluate patient fac...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2018-03, Vol.26 (3), p.711-718 |
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| creator | Krych, Aaron J. O’Malley, Michael P. Johnson, Nick R. Mohan, Rohith Hewett, Timothy E. Stuart, Michael J. Dahm, Diane L. |
| description | Purpose
Medial patellofemoral ligament (MPFL) reconstruction and tibial tubercle osteotomy are commonly used to treat recurrent lateral patellar instability, yet there are limited available data on return to sport (RTS) following these procedures. The purpose of this study is to evaluate patient factors associated with excellent functional outcomes, including successful RTS, following surgical stabilization including MPFL reconstruction in competitive athletes with recurrent lateral patellar instability.
Methods
Athletes undergoing primary MPFL reconstruction for recurrent lateral instability from 2005 to 2013 were identified at a single institution. Concomitant procedures, such as tibial tubercle osteotomy (TTO), were included. Patient demographic information, including BMI, gender, age, and pre-injury Tegner score, was recorded. In addition, radiographs were reviewed for pre-operative patellar height (Caton–Deschamps index) and trochlear dysplasia (Dejour classification). All patients underwent a standardized rehabilitation/post-operative protocol, with isokinetic strength and functional testing being performed at 6 months post-operatively. Final Tegner scores, RTS status, subjective instability ratings, and Kujala scores were collected at a minimum of 2 years. Chi-squared analysis for categorical variables and Wilcoxon rank-sum analysis for continuous variables were used to determine the relationship between the previously mentioned patient and knee characteristics with isokinetic data, RTS status, or Kujala scores.
Results
Thirty-nine athletes (23 male, 16 female) at a mean age of 17.5 ± 2.9 years (range, 13–26) underwent primary MPFL reconstruction (32 autografts, seven allografts) for recurrent patellar instability with a mean follow-up of 47.0 ± 16.4 months. Sixteen patients (41%) underwent concomitant tibial tubercle osteotomies. Isokinetic data collected at 6 months post-operatively demonstrated mean knee flexion and extension strength deficits of 15.8 ± 10.1% and 21.4 ± 14.3%, respectively, compared to the contralateral leg (
p
|
| doi_str_mv | 10.1007/s00167-016-4409-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1853740743</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2008258105</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-6aab9d78d51bd5b6982fa0e4af8f4a92f90e0f089fed31104495b7647531d873</originalsourceid><addsrcrecordid>eNp1UU2LFDEQDaK4s6M_wIsEvHhpraSTTnKUZdcVFrzsPaS7kzVLJmmTtDL-A_-1aWZUELxUFdR7rz4eQq8IvCMA4n0BIIPoWugYA9XRJ2hHWN93omfiKdqBYrSjwIcLdFnKI0ArmXqOLqgEKvmgdujnzRqn6lM0AVdbqo8P2MQZZ1vXHHFNuCwpV-xSCOn71i3VjD74H2Zj4bLmB5uPrZ8bZ1pztrHiYKrNTXFpOQSTsY9nWj22Gk_psNjqq_9msalfgm2jX6BnzoRiX57zHt3fXN9f3XZ3nz9-uvpw102sl7UbjBnVLOTMyTjzcVCSOgOWGScdM4o6BRYcSOXs3BMCjCk-ioEJ3pNZin6P3p5kl5y-ru1iffBl2raMNq1FE8l7wUC0N-7Rm3-gj6k9pS2nKYCkXBLgDUVOqCmnUrJ1esn-YPJRE9CbTfpkk25BbzZp2jivz8rreLDzH8ZvXxqAngCltWL78N_R_1f9BW_6oLs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2008258105</pqid></control><display><type>article</type><title>Functional testing and return to sport following stabilization surgery for recurrent lateral patellar instability in competitive athletes</title><source>SpringerNature Journals</source><source>Access via Wiley Online Library</source><creator>Krych, Aaron J. ; O’Malley, Michael P. ; Johnson, Nick R. ; Mohan, Rohith ; Hewett, Timothy E. ; Stuart, Michael J. ; Dahm, Diane L.</creator><creatorcontrib>Krych, Aaron J. ; O’Malley, Michael P. ; Johnson, Nick R. ; Mohan, Rohith ; Hewett, Timothy E. ; Stuart, Michael J. ; Dahm, Diane L.</creatorcontrib><description>Purpose
Medial patellofemoral ligament (MPFL) reconstruction and tibial tubercle osteotomy are commonly used to treat recurrent lateral patellar instability, yet there are limited available data on return to sport (RTS) following these procedures. The purpose of this study is to evaluate patient factors associated with excellent functional outcomes, including successful RTS, following surgical stabilization including MPFL reconstruction in competitive athletes with recurrent lateral patellar instability.
Methods
Athletes undergoing primary MPFL reconstruction for recurrent lateral instability from 2005 to 2013 were identified at a single institution. Concomitant procedures, such as tibial tubercle osteotomy (TTO), were included. Patient demographic information, including BMI, gender, age, and pre-injury Tegner score, was recorded. In addition, radiographs were reviewed for pre-operative patellar height (Caton–Deschamps index) and trochlear dysplasia (Dejour classification). All patients underwent a standardized rehabilitation/post-operative protocol, with isokinetic strength and functional testing being performed at 6 months post-operatively. Final Tegner scores, RTS status, subjective instability ratings, and Kujala scores were collected at a minimum of 2 years. Chi-squared analysis for categorical variables and Wilcoxon rank-sum analysis for continuous variables were used to determine the relationship between the previously mentioned patient and knee characteristics with isokinetic data, RTS status, or Kujala scores.
Results
Thirty-nine athletes (23 male, 16 female) at a mean age of 17.5 ± 2.9 years (range, 13–26) underwent primary MPFL reconstruction (32 autografts, seven allografts) for recurrent patellar instability with a mean follow-up of 47.0 ± 16.4 months. Sixteen patients (41%) underwent concomitant tibial tubercle osteotomies. Isokinetic data collected at 6 months post-operatively demonstrated mean knee flexion and extension strength deficits of 15.8 ± 10.1% and 21.4 ± 14.3%, respectively, compared to the contralateral leg (
p
< 0.001 for both). Patients who underwent concomitant tibial tubercle osteotomy (
p
= 0.04), males (
p
= 0.01) and those with patella alta (
p
= 0.04) had weaker 6-month isokinetic testing. Thirty-three of the thirty-nine (85%) athletes were able to RTS at a mean of 8.1 ± 3.9 months. Patients undergoing MPFL with concomitant TTO (
p
= 0.02) returned to sport at a slower rate. One patient (3%) reported an episode of recurrent dislocation requiring revision surgery. Kujala and Tegner scores at final follow-up were 91.1 ± 6.3 and 6 (range, 4–9), respectively.
Conclusion
Surgical stabilization including MFPL reconstruction for recurrent lateral patellar instability is an effective procedure for returning athletes to competitive sports. However, strength deficits persist at 6 months after surgery, especially in those undergoing concomitant TTO, which may delay return to sport. Physicians can use these results to counsel patients that return to competitive sports is safe with good clinical outcomes and low rate of recurrence at 4-year follow-up; however, predisposing factors, like a lateralized tibial tubercle, should be addressed if necessary, but athletes should be counselled that a slower recovery and longer return to sport time may be expected.
Level of evidence
IV.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-016-4409-2</identifier><identifier>PMID: 28028569</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Allografts ; Athletes ; Autografts ; Biocompatibility ; Biomedical materials ; Body mass ; Continuity (mathematics) ; Demographics ; Dislocation ; Dislocations ; Dysplasia ; Functional testing ; Isokinetic strength ; Knee ; Lateral stability ; Males ; Medical personnel ; Medicine ; Medicine & Public Health ; Orthopedics ; Osteotomy ; Patients ; Physicians ; Radiographs ; Radiography ; Recovery of function ; Rehabilitation ; Surgery</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2018-03, Vol.26 (3), p.711-718</ispartof><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2016</rights><rights>Knee Surgery, Sports Traumatology, Arthroscopy is a copyright of Springer, (2016). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-6aab9d78d51bd5b6982fa0e4af8f4a92f90e0f089fed31104495b7647531d873</citedby><cites>FETCH-LOGICAL-c438t-6aab9d78d51bd5b6982fa0e4af8f4a92f90e0f089fed31104495b7647531d873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-016-4409-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-016-4409-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27926,27927,41490,42559,51321</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28028569$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Krych, Aaron J.</creatorcontrib><creatorcontrib>O’Malley, Michael P.</creatorcontrib><creatorcontrib>Johnson, Nick R.</creatorcontrib><creatorcontrib>Mohan, Rohith</creatorcontrib><creatorcontrib>Hewett, Timothy E.</creatorcontrib><creatorcontrib>Stuart, Michael J.</creatorcontrib><creatorcontrib>Dahm, Diane L.</creatorcontrib><title>Functional testing and return to sport following stabilization surgery for recurrent lateral patellar instability in competitive athletes</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
Medial patellofemoral ligament (MPFL) reconstruction and tibial tubercle osteotomy are commonly used to treat recurrent lateral patellar instability, yet there are limited available data on return to sport (RTS) following these procedures. The purpose of this study is to evaluate patient factors associated with excellent functional outcomes, including successful RTS, following surgical stabilization including MPFL reconstruction in competitive athletes with recurrent lateral patellar instability.
Methods
Athletes undergoing primary MPFL reconstruction for recurrent lateral instability from 2005 to 2013 were identified at a single institution. Concomitant procedures, such as tibial tubercle osteotomy (TTO), were included. Patient demographic information, including BMI, gender, age, and pre-injury Tegner score, was recorded. In addition, radiographs were reviewed for pre-operative patellar height (Caton–Deschamps index) and trochlear dysplasia (Dejour classification). All patients underwent a standardized rehabilitation/post-operative protocol, with isokinetic strength and functional testing being performed at 6 months post-operatively. Final Tegner scores, RTS status, subjective instability ratings, and Kujala scores were collected at a minimum of 2 years. Chi-squared analysis for categorical variables and Wilcoxon rank-sum analysis for continuous variables were used to determine the relationship between the previously mentioned patient and knee characteristics with isokinetic data, RTS status, or Kujala scores.
Results
Thirty-nine athletes (23 male, 16 female) at a mean age of 17.5 ± 2.9 years (range, 13–26) underwent primary MPFL reconstruction (32 autografts, seven allografts) for recurrent patellar instability with a mean follow-up of 47.0 ± 16.4 months. Sixteen patients (41%) underwent concomitant tibial tubercle osteotomies. Isokinetic data collected at 6 months post-operatively demonstrated mean knee flexion and extension strength deficits of 15.8 ± 10.1% and 21.4 ± 14.3%, respectively, compared to the contralateral leg (
p
< 0.001 for both). Patients who underwent concomitant tibial tubercle osteotomy (
p
= 0.04), males (
p
= 0.01) and those with patella alta (
p
= 0.04) had weaker 6-month isokinetic testing. Thirty-three of the thirty-nine (85%) athletes were able to RTS at a mean of 8.1 ± 3.9 months. Patients undergoing MPFL with concomitant TTO (
p
= 0.02) returned to sport at a slower rate. One patient (3%) reported an episode of recurrent dislocation requiring revision surgery. Kujala and Tegner scores at final follow-up were 91.1 ± 6.3 and 6 (range, 4–9), respectively.
Conclusion
Surgical stabilization including MFPL reconstruction for recurrent lateral patellar instability is an effective procedure for returning athletes to competitive sports. However, strength deficits persist at 6 months after surgery, especially in those undergoing concomitant TTO, which may delay return to sport. Physicians can use these results to counsel patients that return to competitive sports is safe with good clinical outcomes and low rate of recurrence at 4-year follow-up; however, predisposing factors, like a lateralized tibial tubercle, should be addressed if necessary, but athletes should be counselled that a slower recovery and longer return to sport time may be expected.
Level of evidence
IV.</description><subject>Allografts</subject><subject>Athletes</subject><subject>Autografts</subject><subject>Biocompatibility</subject><subject>Biomedical materials</subject><subject>Body mass</subject><subject>Continuity (mathematics)</subject><subject>Demographics</subject><subject>Dislocation</subject><subject>Dislocations</subject><subject>Dysplasia</subject><subject>Functional testing</subject><subject>Isokinetic strength</subject><subject>Knee</subject><subject>Lateral stability</subject><subject>Males</subject><subject>Medical personnel</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Osteotomy</subject><subject>Patients</subject><subject>Physicians</subject><subject>Radiographs</subject><subject>Radiography</subject><subject>Recovery of function</subject><subject>Rehabilitation</subject><subject>Surgery</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1UU2LFDEQDaK4s6M_wIsEvHhpraSTTnKUZdcVFrzsPaS7kzVLJmmTtDL-A_-1aWZUELxUFdR7rz4eQq8IvCMA4n0BIIPoWugYA9XRJ2hHWN93omfiKdqBYrSjwIcLdFnKI0ArmXqOLqgEKvmgdujnzRqn6lM0AVdbqo8P2MQZZ1vXHHFNuCwpV-xSCOn71i3VjD74H2Zj4bLmB5uPrZ8bZ1pztrHiYKrNTXFpOQSTsY9nWj22Gk_psNjqq_9msalfgm2jX6BnzoRiX57zHt3fXN9f3XZ3nz9-uvpw102sl7UbjBnVLOTMyTjzcVCSOgOWGScdM4o6BRYcSOXs3BMCjCk-ioEJ3pNZin6P3p5kl5y-ru1iffBl2raMNq1FE8l7wUC0N-7Rm3-gj6k9pS2nKYCkXBLgDUVOqCmnUrJ1esn-YPJRE9CbTfpkk25BbzZp2jivz8rreLDzH8ZvXxqAngCltWL78N_R_1f9BW_6oLs</recordid><startdate>20180301</startdate><enddate>20180301</enddate><creator>Krych, Aaron J.</creator><creator>O’Malley, Michael P.</creator><creator>Johnson, Nick R.</creator><creator>Mohan, Rohith</creator><creator>Hewett, Timothy E.</creator><creator>Stuart, Michael J.</creator><creator>Dahm, Diane L.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20180301</creationdate><title>Functional testing and return to sport following stabilization surgery for recurrent lateral patellar instability in competitive athletes</title><author>Krych, Aaron J. ; O’Malley, Michael P. ; Johnson, Nick R. ; Mohan, Rohith ; Hewett, Timothy E. ; Stuart, Michael J. ; Dahm, Diane L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-6aab9d78d51bd5b6982fa0e4af8f4a92f90e0f089fed31104495b7647531d873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Allografts</topic><topic>Athletes</topic><topic>Autografts</topic><topic>Biocompatibility</topic><topic>Biomedical materials</topic><topic>Body mass</topic><topic>Continuity (mathematics)</topic><topic>Demographics</topic><topic>Dislocation</topic><topic>Dislocations</topic><topic>Dysplasia</topic><topic>Functional testing</topic><topic>Isokinetic strength</topic><topic>Knee</topic><topic>Lateral stability</topic><topic>Males</topic><topic>Medical personnel</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Osteotomy</topic><topic>Patients</topic><topic>Physicians</topic><topic>Radiographs</topic><topic>Radiography</topic><topic>Recovery of function</topic><topic>Rehabilitation</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Krych, Aaron J.</creatorcontrib><creatorcontrib>O’Malley, Michael P.</creatorcontrib><creatorcontrib>Johnson, Nick R.</creatorcontrib><creatorcontrib>Mohan, Rohith</creatorcontrib><creatorcontrib>Hewett, Timothy E.</creatorcontrib><creatorcontrib>Stuart, Michael J.</creatorcontrib><creatorcontrib>Dahm, Diane L.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Krych, Aaron J.</au><au>O’Malley, Michael P.</au><au>Johnson, Nick R.</au><au>Mohan, Rohith</au><au>Hewett, Timothy E.</au><au>Stuart, Michael J.</au><au>Dahm, Diane L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Functional testing and return to sport following stabilization surgery for recurrent lateral patellar instability in competitive athletes</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2018-03-01</date><risdate>2018</risdate><volume>26</volume><issue>3</issue><spage>711</spage><epage>718</epage><pages>711-718</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
Medial patellofemoral ligament (MPFL) reconstruction and tibial tubercle osteotomy are commonly used to treat recurrent lateral patellar instability, yet there are limited available data on return to sport (RTS) following these procedures. The purpose of this study is to evaluate patient factors associated with excellent functional outcomes, including successful RTS, following surgical stabilization including MPFL reconstruction in competitive athletes with recurrent lateral patellar instability.
Methods
Athletes undergoing primary MPFL reconstruction for recurrent lateral instability from 2005 to 2013 were identified at a single institution. Concomitant procedures, such as tibial tubercle osteotomy (TTO), were included. Patient demographic information, including BMI, gender, age, and pre-injury Tegner score, was recorded. In addition, radiographs were reviewed for pre-operative patellar height (Caton–Deschamps index) and trochlear dysplasia (Dejour classification). All patients underwent a standardized rehabilitation/post-operative protocol, with isokinetic strength and functional testing being performed at 6 months post-operatively. Final Tegner scores, RTS status, subjective instability ratings, and Kujala scores were collected at a minimum of 2 years. Chi-squared analysis for categorical variables and Wilcoxon rank-sum analysis for continuous variables were used to determine the relationship between the previously mentioned patient and knee characteristics with isokinetic data, RTS status, or Kujala scores.
Results
Thirty-nine athletes (23 male, 16 female) at a mean age of 17.5 ± 2.9 years (range, 13–26) underwent primary MPFL reconstruction (32 autografts, seven allografts) for recurrent patellar instability with a mean follow-up of 47.0 ± 16.4 months. Sixteen patients (41%) underwent concomitant tibial tubercle osteotomies. Isokinetic data collected at 6 months post-operatively demonstrated mean knee flexion and extension strength deficits of 15.8 ± 10.1% and 21.4 ± 14.3%, respectively, compared to the contralateral leg (
p
< 0.001 for both). Patients who underwent concomitant tibial tubercle osteotomy (
p
= 0.04), males (
p
= 0.01) and those with patella alta (
p
= 0.04) had weaker 6-month isokinetic testing. Thirty-three of the thirty-nine (85%) athletes were able to RTS at a mean of 8.1 ± 3.9 months. Patients undergoing MPFL with concomitant TTO (
p
= 0.02) returned to sport at a slower rate. One patient (3%) reported an episode of recurrent dislocation requiring revision surgery. Kujala and Tegner scores at final follow-up were 91.1 ± 6.3 and 6 (range, 4–9), respectively.
Conclusion
Surgical stabilization including MFPL reconstruction for recurrent lateral patellar instability is an effective procedure for returning athletes to competitive sports. However, strength deficits persist at 6 months after surgery, especially in those undergoing concomitant TTO, which may delay return to sport. Physicians can use these results to counsel patients that return to competitive sports is safe with good clinical outcomes and low rate of recurrence at 4-year follow-up; however, predisposing factors, like a lateralized tibial tubercle, should be addressed if necessary, but athletes should be counselled that a slower recovery and longer return to sport time may be expected.
Level of evidence
IV.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28028569</pmid><doi>10.1007/s00167-016-4409-2</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2018-03, Vol.26 (3), p.711-718 |
| issn | 0942-2056 1433-7347 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1853740743 |
| source | SpringerNature Journals; Access via Wiley Online Library |
| subjects | Allografts Athletes Autografts Biocompatibility Biomedical materials Body mass Continuity (mathematics) Demographics Dislocation Dislocations Dysplasia Functional testing Isokinetic strength Knee Lateral stability Males Medical personnel Medicine Medicine & Public Health Orthopedics Osteotomy Patients Physicians Radiographs Radiography Recovery of function Rehabilitation Surgery |
| title | Functional testing and return to sport following stabilization surgery for recurrent lateral patellar instability in competitive athletes |
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