Patellar Morphology in Recurrent Lateral Patellofemoral Instability: Associations With Risk Factors and Postoperative...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanics

Background:

• Patellar morphology, assessed by the Wiberg classification, is a potential risk factor for recurrent lateral patellofemoral instability.
• The clinical utility of the Wiberg classification in this patient population is not well-established.

Purpose of the Study:

• Determine the incidence of Wiberg types and their relationship with risk factors in patients with recurrent lateral patellofemoral instability.
• Evaluate the association between Wiberg classification and disease-specific quality of life outcomes post-MPFL reconstruction.

Main Methods:

• A cohort of 447 patients undergoing MPFL reconstruction for recurrent instability was analyzed.
• Intrarater reliability of the Wiberg classification was assessed. Ordinal logistic regression explored relationships with risk factors.
• Analysis of Variance (ANOVA) compared pre- and postoperative Banff Patellofemoral Instability Instrument (BPII) scores across Wiberg types.

Main Results:

• The Wiberg classification showed substantial intrarater agreement (κw = 0.75).
• Trochlear dysplasia, age at first dislocation, and WARPS/STAID score predicted Wiberg type (P < .001).
• No significant differences in pre- or postoperative BPII scores were found between Wiberg types.

Conclusions:

• In recurrent patellofemoral instability, Wiberg classification is predicted by trochlear dysplasia, WARPS/STAID score, and age at first dislocation.
• The Wiberg classification does not appear to correlate with quality of life outcomes (BPII scores) following MPFL reconstruction.