Medial Retinacular Plication Versus Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability

Meir Medical Center30 enrolled

Overview

The purpose of this study is to determine whether medial patellofemoral ligament reconstruction results in superior functional outcomes compared to medial retinacular plication surgery in cases of recurrent patellar instability.

Patients with recurrent lateral patellar instability will be assigned to undergo one of two surgical approaches aimed to prevent recurrent patellar instability and result in improvement in function. One surgical approach will be medial retinacular plication with multiple stitches while the other surgical approach will include medial patellofemoral ligament reconstruction using a hamstring tendon graft. Prior to surgery, and then during follow-up after surgery as well as at the completion of minimum two years follow-up after surgery, patients will be asked to complete subjective functional questionaires that will rate their knee function, and to undergo detailed physical examination and objective functional tests that will quantify the success of surgery. The outcomes of the surgical treatment options will be compared to determine whether medial patellofemoral ligament reconstruction results in superior function and patient subjective satisfaction compared to medial retinacular plication only.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Patella, Familial Recurrent Dislocation Of

Interventions

Surgical treatment for recurrent patellar instabilityPROCEDURE

Either medial plication or MPFL reconstructuion surgery

Eligibility

Sex: ALLMin age: 15 YearsMax age: 35 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Recurrent lateral patellar instability has been described by the patient Imaging criteria include: * TT-TG distance (on CT or MRI) is between 10-20 mm * Insall-Salvati Index is between 0.9 - 1.2 * Trochlea angle is lower than 145 degrees Exclusion Criteria: * Only a single event of lateral patellar instability occured Imaging criteria include: * TT-TG distance (on CT or MRI) is below 10 mm or above 20 mm * Insall-Salvati Index is below 0.9 or above 1.2 * Trochlea angle is above 145 degrees * Other concomitant intra-articular patholgies, injuries, and surgeries, besides the patella instability, with were recorded at the lower limbs and did not uneventfuly healed, and as a result cause dysfunction of the lower limbs * Significant ligamentous injuries of the knees, including cruciate and collateral injuries, as well as meniscal injuries that interfere with function

Locations (1)

Meir Medical Center

Kfar Saba, Israel

RECRUITING

Outcomes

Primary Outcomes

Kujala knee outcome score

A validated international outcome score that evaluates knee functional outcome in relation to patellofemoral symptoms