Document Detail


Medial patellofemoral ligament reconstruction for recurrent patellar dislocation: a systematic review including rehabilitation and return-to-sports efficacy.
MedLine Citation:
PMID:  20887937     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We systematically reviewed the evaluated efficacy of medial patellofemoral ligament (MPFL) reconstruction, rehabilitation, and patient outcomes for safely returning patients to sports.
METHODS: We performed a literature search using the Ovid Medline database from 1950 to present, as well as the SportDiscus and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases. Only English-language studies that described MPFL reconstruction or repair, rehabilitation, and patient outcome information were included. Search terms were combinations of "MPFL repair," "MPFL reconstruction," "patellofemoral ligament," "patellar dislocation," "patient outcome," and "rehabilitation." Coleman Methodology Scores were used to evaluate research quality.
RESULTS: A total of 21 studies (11 prospective and 10 retrospective) met our inclusion criteria, with a total of 488 patients (184 male and 304 female patients) and 510 knees contributing to this review. Most patients were female (62.3%), and the mean age at surgery was 23.4 years (range, 6 to 52 years). Semitendinosus autografts were most commonly used (n = 145 [28.4%]). Of all reported complications at follow-up (n = 155), quadriceps dysfunction (n = 48 [31.0%]), positive apprehension (n = 32 [20.6%]), and decreased knee range of motion (n = 28 [18.1%]) were most common. Although inclusion criteria required rehabilitation information, the level of description was generally limited to acute care rehabilitation, with insufficient progressive exercise descriptions. Coleman Methodology Scores (58.76 ± 8.6) indicated generally poor study methodologies.
CONCLUSIONS: MPFL reconstruction and rehabilitation are likely to improve a patient's ability to perform activities of daily living. Poor study methodology including outcome surveys that lack either sensitivity or validity to measure the influence of patellofemoral joint dysfunction on sports participation, as well as limited exercise rehabilitation information, make it difficult to determine efficacy. Recommendations for improved outcome measurements and more comprehensive functional rehabilitation are provided.
LEVEL OF EVIDENCE: Level IV, systematic review.
Authors:
Brent Fisher; John Nyland; Emily Brand; Brian Curtin
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  26     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2011-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1384-94     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Sports Medicine, Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky 40202, USA.
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MeSH Terms
Descriptor/Qualifier:
Female
Humans
Ligaments / surgery*
Ligaments, Articular / surgery*,  transplantation
MEDLINE
Male
Patellar Dislocation / rehabilitation,  surgery*
Patellofemoral Joint / surgery*
Recurrence
Sports*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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