In a retrospective cohort review of 142 consecutive skeletally immature patients who sustained a first-time patella dislocation, Kristen Reikersdorfer, BA, and colleagues compared 90 patients treated nonoperatively with 52 patients who chose combined medial patellofemoral ligament and medial quadriceps tendon femoral ligament reconstruction. Patients had a lower risk of postoperative instability (15.4% vs. 58.8%), were more likely to return to sports (88.5% vs. 66.2%) and had better Kujala, Tegner and IKDC scores if they underwent surgery. Surgically treated patients experienced recurrent instability 15.4% of the time, and 11.5% experienced postoperative complications.
PFF Board Member Dr. Andrew J. Cosgarea reviewed the study and opined on its conclusions. He wrote that Reikersdorfer’s paper supported the findings of previous studies showing that young patients sustaining a first-time dislocation have better functional outcomes and are less likely to dislocate after surgical stabilization compared with those treated nonoperatively.
“It also reminds us that even in the hands of experienced surgeons, recurrent instability and surgical complications can occur to a substantial number of patients,” Dr. Cosgarea continued. “These findings reinforce the need for an ongoing effort to identify the physiologic and morphologic factors that put patients at the highest and lowest risk of recurrence following first-time dislocation, so that patients and their families have as much information as possible to decide which treatment approach they would like to pursue.”
For a complete article on the findings of Reikersdorfer and her colleagues, click here.