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F. Chotel, A. Peltier, A. Viste, M.M. Chaker, J. Bérard
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Results
Initial experience with MPFL
This is about the 13first patients (series presented
at 2010 EPOS meeting) [3]. No permanent or
habitual dislocation was included in this study.
Inclusion criteria were:
i)
major objective patella
instability with 2 or more patella dislocations,
ii)
all trochlear dysplasia/apprehension test +
(fig. 3),
iii)
no previous surgery.
After a mean of 10.5 months (range, 3-23)
follow-up after surgery, no recurrent episodes
of dislocation or subluxation were reported.
Mean Kujala score was of 90.2 (range, 84-99)
at latest follow-up. For all patients the moving
patellar apprehension test was positive before
and negative after surgery. A firm end point to
lateral patellar translation was noticed in all
patients at latest follow-up (fig. 4).
Objective assessment with CT noted that the
patellar tilt on relaxed quadriceps was
significantly improved from 28° preoperatively
(range, 16-41) to 16° at follow-up (range, 7-32).
The patellar tilt on contracted quadriceps was
significantly improved from 35° preoperatively
(range, 21-52) to 24.6° at follow-up (range, 11-
48) (fig. 5).
Fig.3:Typicalpositivemovingpatellarapprehension
test (look at patient’s hands).
Fig. 4: In our experience, moving patellar apprehe
nsion test (or Smilie test) was always find negative
post-operatively in the series treated with MPFL
reconstruction.
Fig. 5: Patellar tilt during
contracted Q and CT scan.
Before and after MPFL
reconstruction in a young
child with habitual patella
dislocation. The patella
tunnel can be noticed.