Visual analog scale assessment after medial patellofemoral ligament reconstruction: with or without tibial tubercle
Toshifumi Watanabe1, Takeshi Muneta, Hiroo Ikeda
1Department of Orthopaedic Surgery, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan.
Background:
We studied the efficacy of medial patellofemoral ligament (MPFL) reconstruction, with or without tibial tubercle (TT) transfer, for recurrent dislocation of the patella, based on subjective functional assessment using the visual analog scale (VAS).
Methods:
Forty-two consecutive knees of 40 patients who underwent MPFL reconstruction using a hamstring tendon were followed up for an average of 4.3 years. Twenty-nine knees underwent MPFL reconstruction (MPFL group) and 13 knees underwent MPFL reconstruction combined with medial transfer of TT (TT+MPFL group). Clinical results, including the VAS score at the latest follow-up in both groups, were assessed.
Results:
An apparent deficit in the range of motion was observed in two cases from the TT+MPFL group. The ratio of negative apprehension test was significantly improved from 3% preoperatively to 79% postoperatively in the MPFL group and from 8% to 69% in the TT+MPFL group. The Lysholm scores were significantly improved from 70 points preoperatively to 92 points postoperatively in the MPFL group and from 72 points to 90 points in the TT+MPFL group. There was no significant difference between the two groups in the ratios of negative apprehension tests and the Lysholm scores after surgery as well as before surgery. In the VAS assessment, the MPFL group scored significantly higher than the TT+MPFL group in "Japanese full sitting" (average score 92 vs 62). The scores of the two groups were not significantly different in any of the other items, although the total average score was significantly higher in the MPFL group (91 vs 81).
Conclusions:
MPFL reconstruction without TT transfer achieved satisfactory results including high scores on subjective functional assessments without disadvantage caused by the TT transfer. Isolated MPFL reconstruction has been suggested to be a useful treatment method for recurrent dislocation of the patella.