Femoral tunnel enlargement after medial patellofemoral ligament reconstruction: Prevalence, risk factors, and clinical effect

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dc.contributor.authorBerard J.-B.
dc.contributor.authorMagnussen R.A.
dc.contributor.authorBonjean G.
dc.contributor.authorOzcan S.
dc.contributor.authorLustig S.
dc.contributor.authorNeyret P.
dc.contributor.authorServien E.
dc.date.accessioned2019-10-26T21:28:08Z
dc.date.available2019-10-26T21:28:08Z
dc.date.issued2014
dc.departmentEge Üniversitesien_US
dc.description.abstractBackground: In recent years, significantly more attention has been focused on the role of the medial patellofemoral ligament (MPFL) in patellar stability, and MPFL reconstruction has become a mainstay of surgical treatment of episodic patellar dislocations. Although previously described in detail after reconstruction of the anterior cruciate ligament, tunnel enlargement has not been investigated after MPFL reconstruction. Hypotheses: (1) Femoral tunnel enlargement occurs after MPFL reconstruction. (2) Patella alta, trochlear dysplasia, and tunnel malposition are risk factors for tunnel enlargement. (3) The presence of tunnel enlargement is not associated with recurrent dislocations or poorer patient-reported outcome scores after MPFL reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: Fifty-five of 59 knees treated for episodic patellar dislocations with MPFL reconstruction between 2005 and 2010 were evaluated at 1 year postoperatively for the presence of tunnel enlargement on lateral radiographs. Tunnel enlargement was defined as a tunnel area greater than 2 times that of the original tunnel. Knees with tunnel enlargement at 1 year were compared with those without tunnel enlargement. Patients were assessed for recurrent subluxations or dislocations at a mean of 3 years postoperatively, and patient-reported outcome scores were assessed in a subset of patients at a mean of 3.7 years postoperatively. Results: Tunnel enlargement was noted in 23 knees (41.8%). No differences in patient age or body mass index were noted between the 2 groups. The mean patellar height was significantly higher in the enlarged tunnel group (P = .03). A higher prevalence of trochlear dysplasia or tunnel malposition was not demonstrated in the enlarged tunnel group. Patient-reported outcome scores and the risk of recurrent patellar instability were equal in the 2 groups. Conclusion: Femoral tunnel enlargement after MPFL reconstruction is common, with patients with patella alta at an increased risk. The influence of tunnel malposition and trochlear dysplasia on this condition requires further research. Recurrent instability and patient-reported outcome scores are not affected by tunnel enlargement. © 2013 The Author(s).en_US
dc.identifier.doi10.1177/0363546513512771en_US
dc.identifier.endpage301en_US
dc.identifier.issn0363-5465
dc.identifier.issue2en_US
dc.identifier.pmid24318612en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage297en_US
dc.identifier.urihttps://doi.org/10.1177/0363546513512771
dc.identifier.urihttps://hdl.handle.net/11454/17464
dc.identifier.volume42en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.relation.ispartofAmerican Journal of Sports Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectmedial patellofemoral ligamenten_US
dc.subjectoutcomeen_US
dc.subjectprevalenceen_US
dc.subjectreconstructionen_US
dc.subjecttunnel enlargementen_US
dc.titleFemoral tunnel enlargement after medial patellofemoral ligament reconstruction: Prevalence, risk factors, and clinical effecten_US
dc.typeArticleen_US

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