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Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction
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Ligament reconstruction versus distal realignment for patellar dislocation.

Petri Sillanpää1, Ville M Mattila, Tuomo Visuri

  • 1Centre for Military Medicine, Lahti, Finland. petri.sillanpaa@uta.fi

Clinical Orthopaedics and Related Research
|March 19, 2008
PubMed
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Adductor magnus tenodesis is a reliable surgical option for recurrent patellar dislocation, showing fewer redislocations and reduced risk of osteoarthritis compared to distal patellar realignment.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanical Research

Background:

  • Recurrent patellar dislocation necessitates effective treatment strategies.
  • Medial patellofemoral ligament reconstruction is increasingly utilized.
  • Long-term outcomes and comparative effectiveness of different reconstruction techniques require investigation.

Purpose of the Study:

  • To compare adductor magnus tenodesis with distal patellar realignment for recurrent patellar dislocation.
  • To evaluate redislocation rates, functional outcomes, and the development of patellofemoral osteoarthritis at 10-year follow-up.

Main Methods:

  • A comparative study of 47 patients with recurrent patellar dislocation treated between 1994 and 2000.
  • Patients underwent either adductor magnus tenodesis (18 knees) or Roux-Goldthwait procedure (29 knees).

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  • Outcomes assessed included redislocations, Kujala scores, and magnetic resonance imaging (MRI) for cartilage lesions and osteoarthritis.

    • Main Results:

    • Adductor magnus tenodesis group had a 7% redislocation rate versus 14% in the Roux-Goldthwait group.
    • Median Kujala scores were comparable (88 vs. 86).
    • MRI revealed patellofemoral cartilage lesions in 73.3% of knees; osteoarthritis was observed in 5 patients (Roux-Goldthwait) but none in the adductor magnus group.

    Conclusions:

    • Adductor magnus tenodesis demonstrates reliability in treating recurrent patellar dislocation.
    • Medial patellofemoral ligament reconstruction via adductor magnus tenodesis may lower the risk of developing patellofemoral osteoarthritis compared to distal realignment.
    • Long-term follow-up highlights the importance of surgical technique in mitigating degenerative joint changes.