Artikel
Medial Patellofemoral Ligament (MPFL) Reconstruction Using Quadriceps- or Hamstring- Tendon Autograft: A Matched-Pairs Analysis
Suche in Medline nach
Autoren
-
Armin Runer
- Univesitätsklinik für Orthopädie und Traumatologie, Innsbruck, Austria
-
Stefan Klotz
- Univesitätsklinik für Orthopädie und Traumatologie, Innsbruck, Austria
-
Peter Gföller
- Gelenkpunkt - Sport und Gelenkchirurgie, Innsbruck, Austria
-
Friedemann Schneider
- Universitätsklinik für Orthopädie und Traumatologie, Innsbruck, Austria
-
Raul Mayr
- Universitätsklinik für Orthopädie und Traumatologie, Innsbruck, Austria
-
Christoph Raas
- Universitätsklinik für Orthopädie und Traumatologie, Innsbruck, Austria
-
Christian Fink
- Gelenkpunkt - Sport und Gelenkchirurgie, Innsbruck, Austria
-
Michael Liebensteiner
- Universitätsklinik für Orthopädie und Traumatologie, Innsbruck, Austria
| Veröffentlicht: | 26. Oktober 2021 |
|---|
Gliederung
Text
Objectives: To compare clinical and patient-reported outcome measurements (PROMs) two years after minimally invasive MPFL reconstruction (MPFL-R) using either Gracilis tendon- (GT) or quadriceps tendon- (QT) autografts.
Methods: Within a time period of 3 years, a total of 129 MPFL-R using either a partial thickness autologous quadriceps tendon strip (n=50) or a gracilis tendon autograft (n=79) were performed. Only patients with isolated MPFL-R were included in the study and invited for follow-up (FU). Patients with concomitant chondral or ligamentous injuries, high grades of trochlear dysplasia, Caton-Deschamps ratio > 1.3, TTTG>20mm, rotational deformities or additional surgical interventions were excluded.
Twenty-eight patients with isolated GT-MPFL-R were matched with respect to gender (perfect match) and age (±5 years) to 50 patients treated with isolated QT-MPFL reconstruction. All patients were evaluated clinically and with PROMs (Tegner activity level, Lysholm-, Kujala- and VAS for pain score) at a minimum of two years of follow-up.
Results: After matching, a total of 56 patients (QT: n=28, GT: n=28, 46.4% women) with a mean age of 20.4±5.8 were included in the study. The average FU was 26.3±5.3 months.
The mean Lysholm- (GT: 84.3±13.0, QT: 89.7±8.1, p=.22) and Kujala- (GT: 89.0±10.3, QT: 93.3±5.1, p=.53) score did not significantly differ between both groups at final FU. TAL was significantly higher (GT: 4.7±2.0, 6.1±2.1, p=.02) and VAS for pain significantly lower (GT: 2.2±1.9, QT: 0.8±1.1, p=.01) in the QT-group. "Excellent" or "good" results were reported in 17 (60.7%) and 23 (82.1%) GT- and QT-patients respectively (p=.08). "No pain" or "slight pain" during severe exertion was reported in 12 (42.8%) patients treated with GT-A and 22 (78.6%) patients treated with QT-A (p=.006). No patellar re-luxation or fracture occurred in either group.
Conclusion: MPFL reconstruction using GT-A yields similar patient-reported outcomes compared to QT-A but significantly higher pain levels at two years follow-up.
