Indications for Medial Patellofemoral Ligament Reconstruction: A Systematic Review (original) (raw)

2015, Journal of Knee Surgery

Patellofemoral instability is reported as the second most common cause of traumatic knee hemarthrosis 1 and is commonly seen in young, active patients. 2,3 Complications following a primary patellofemoral dislocation include redislocation (15-49% 1,3-9 ), patellofemoral pain, 3,10 and patellofemoral osteoarthritis. 3,10 Subjective complaints of giving way, instability, decreased physical activity, diminished function, and reduced quality of life have also been described. Furthermore, studies have shown that up to 55% of patients are unable to return to their previous level of physical activity. 7,8 A long-term study by Cofield and Bryan reported on 48 acute primary dislocations treated conservatively and followed for an average of 11 years. 12 Only 25% of patients reported being asymptomatic, with the remaining patients having complaints ranging from a conscious limitation of their activities to avoiding all vigorous sports. In 1997, Mäenpää et al reported results of a longterm study (13-year mean follow-up) on conservative treatment of acute patellar dislocation. 9 In 25% of cases, retropatellar crepitation was observed during physical examination, which was interpreted as a sign of cartilaginous degeneration.