Combined Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Osteotomy Has a Lower Risk of Recurrent Instability Requiring Revision Stabilization at 2 Years Than Either Procedure Alone
2024

Comparing Knee Surgery Techniques for Patellar Instability

Sample size: 70070 publication Evidence: moderate

Author Information

Author(s): Markes Alexander R. M.D., Ghanta Ramesh B. M.D., Zhang Alan L. M.D., Ma C.Benjamin M.D., Feeley Brian T. M.D., Lansdown Drew A. M.D.

Primary Institution: University of California-San Francisco

Hypothesis

We hypothesized that despite isolated MPFLR being the most common procedure, we would expect increasing use of combined MPFLR and TTO for patellar instability and that combined MPFLR and TTO would have a greater overall complication rate although the lowest rate of recurrent instability compared with isolated MPFLR or TTO.

Conclusion

Isolated MPFLR is the most common modality used for patellar instability, with increasing prevalence and the lowest 2-year complication rate.

Supporting Evidence

  • MPFLR was found to be the most common procedure (73.1%).
  • MPFLR had the lowest overall complication rate (5.4%).
  • Combined MPFLRTTO had a lower risk for revision at 2.4%.

Takeaway

Doctors looked at a lot of patients to see which knee surgery works best for a problem called patellar instability. They found that one type of surgery is done the most and has the fewest problems afterward.

Methodology

The PearlDiver Mariner database was queried for all reported cases of MPLFR, TTO, and combined MPFLRTTO performed between 2010 and 2020 using Current Procedural Terminology codes.

Potential Biases

There may be unknown variables leading to increased risks of some complications evaluated due to the limitations of the database.

Limitations

The study has limitations including the inability to evaluate patient-level factors such as trochlear dysplasia and the reliance on accurate coding of procedures.

Participant Demographics

The study included a predominance of female patients, with the greatest incidence of procedures in those aged 10 to 19 years.

Statistical Information

P-Value

p<0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1016/j.asmr.2024.100994

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