J Knee Surg
DOI: 10.1055/a-2421-5391
Original Article

Incidence of Early Adverse Events Following Medial Patellofemoral Ligament Reconstruction

1   Cleveland Clinic Orthopaedic and Rheumatologic Institute, Garfield Heights, Ohio
,
1   Cleveland Clinic Orthopaedic and Rheumatologic Institute, Garfield Heights, Ohio
,
Lutul D. Farrow
1   Cleveland Clinic Orthopaedic and Rheumatologic Institute, Garfield Heights, Ohio
› Author Affiliations
Funding None.

Abstract

The current literature lacks data regarding perioperative complications after medial patellofemoral ligament reconstruction (MPFLr). The objective of this study was to identify the incidence and predictors of adverse events in the first 90 days after MPFLr. Patients undergoing primary MPFLr between January 1, 2010, and December 31, 2019, were included. Predictors of readmission for any reason were identified using a multivariable logistic regression analysis. A total of 140 MPFLrs were included in the final analysis. Of these, 17 patients (12.1%) were admitted in the first 90 days after MPFLr. The most common reason for readmission was pain (7/140, 5%), followed by cellulitis (5/140, 3.5%). The only major complication was pulmonary embolism experienced by one patient (1/140, 0.7%). Univariate logistic regression analysis demonstrated that patients who ever smoked were 4.5 times (p = 0.005) more likely to be readmitted in the first 90 days. Although additional soft-tissue procedures increased the readmission rated by 21% (p = 0.810) and additional chondral procedure increased by 35% (p = 0.568), the multivariable analysis did not reveal a significant difference. Surgeons can use this information to counsel patients on what to expect following MPFLr.



Publication History

Received: 09 September 2023

Accepted: 22 September 2024

Accepted Manuscript online:
24 September 2024

Article published online:
06 November 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Shah JN, Howard JS, Flanigan DC, Brophy RH, Carey JL, Lattermann C. A systematic review of complications and failures associated with medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med 2012; 40 (08) 1916-1923
  • 2 Nomura E, Inoue M, Osada N. Anatomical analysis of the medial patellofemoral ligament of the knee, especially the femoral attachment. Knee Surg Sports Traumatol Arthrosc 2005; 13 (07) 510-515
  • 3 Farrow LD, Alentado VJ, Abdulnabi Z, Gilmore A, Liu RW. The relationship of the medial patellofemoral ligament attachment to the distal femoral physis. Am J Sports Med 2014; 42 (09) 2214-2218
  • 4 Nguyen CV, Farrow LD, Liu RW, Gilmore A. Safe drilling paths in the distal femoral epiphysis for pediatric medial patellofemoral ligament reconstruction. Am J Sports Med 2017; 45 (05) 1085-1089
  • 5 Schneider DK, Grawe B, Magnussen RA. et al. Outcomes after isolated medial patellofemoral ligament reconstruction for the treatment of recurrent lateral patellar dislocations: a systematic review and meta-analysis. Am J Sports Med 2016; 44 (11) 2993-3005
  • 6 Csintalan RP, Latt LD, Fornalski S, Raiszadeh K, Inacio MC, Fithian DC. Medial patellofemoral ligament (MPFL) reconstruction for the treatment of patellofemoral instability. J Knee Surg 2014; 27 (02) 139-146
  • 7 Zhang L, Li Z. Long-term clinical results of double bundle reconstruction of the medial patellofemoral ligament for patellar instability. J Knee Surg 2019; 32 (02) 153-159
  • 8 Sappey-Marinier E, Sonnery-Cottet B, O'Loughlin P. et al. Clinical outcomes and predictive factors for failure with isolated MPFL reconstruction for recurrent patellar instability: a series of 211 reconstructions with a minimum follow-up of 3 years. Am J Sports Med 2019; 47 (06) 1323-1330
  • 9 Shimizu R, Sumen Y, Sakaridani K, Matsuura M, Adachi N. Middle-to long-term outcome after medial patellofemoral ligament reconstruction with Insall's proximal realignment for patellar instability. Asia Pac J Sports Med Arthrosc Rehabil Technol 2019; 17: 5-9
  • 10 Feller JA, Richmond AK, Wasiak J. Medial patellofemoral ligament reconstruction as an isolated or combined procedure for recurrent patellar instability. Knee Surg Sports Traumatol Arthrosc 2014; 22 (10) 2470-2476
  • 11 Matthews JJ, Schranz P. Reconstruction of the medial patellofemoral ligament using a longitudinal patellar tunnel technique. Int Orthop 2010; 34 (08) 1321-1325
  • 12 Panni AS, Alam M, Cerciello S, Vasso M, Maffulli N. Medial patellofemoral ligament reconstruction with a divergent patellar transverse 2-tunnel technique. Am J Sports Med 2011; 39 (12) 2647-2655
  • 13 Dejour D, Le Coultre B. Osteotomies in patello-femoral instabilities. Sports Med Arthrosc Rev 2007; 15 (01) 39-46
  • 14 Dejour D, Saggin P. The sulcus deepening trochleoplasty: the Lyon's procedure. Int Orthop 2010; 34 (02) 311-316
  • 15 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap): a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 (02) 377-381
  • 16 Stupay KL, Swart E, Shubin Stein BE. Widespread implementation of medial patellofemoral ligament reconstruction for recurrent patellar instability maintains functional outcomes at midterm to long-term follow-up while decreasing complication rates: a systematic review. Arthroscopy 2015; 31 (07) 1372-1380