Evaluation of Differences in Patellar Height After Patellar Stabilization Procedures Not Intended to Address Patella...

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Radiology

Background:

• Conflicting evidence exists regarding whether isolated medial patellofemoral ligament reconstruction (MPFLr) decreases patellar height.
• Patellar height is a critical factor in knee function and stability.

Purpose of the Study:

• To determine if patellar stabilization surgery, even without addressing patella alta, influences patellar height.
• To analyze the effect of different surgical techniques on patellar height.

Main Methods:

• A multicenter retrospective chart review of 356 knees undergoing MPFLr, tibial tuberosity osteotomy (TTO), and/or trochleoplasty.
• Caton-Deschamps index (CDI) calculated from pre- and postoperative radiographs.
• Paired t-tests compared CDI values across different surgical procedures and techniques.

Main Results:

• All analyzed stabilization procedures showed a statistically significant decrease in CDI from pre- to postoperative.
• Isolated MPFLr using a 2-bundle technique resulted in a significant decrease in CDI at 2 weeks postoperatively (ΔCDI = -0.09; P < .001).
• Isolated MPFLr using a 1-bundle technique did not show a significant change in CDI (ΔCDI = -0.01; P = .621).

Conclusions:

• Surgical techniques for patellar stabilization impact patellar height, irrespective of distalizing tibial tuberosity osteotomy.
• A 2-bundle MPFLr technique leads to a significant decrease in patellar height, while a 1-bundle technique does not.
• These findings are crucial for surgical planning and patient counseling regarding patellar height changes after MPFLr.