Aim
Although traditionally considered an indication for tibial tubercle osteotomy, growing evidence suggests that isolated medial patellofemoral ligament (MPFL) reconstruction may provide satisfactory outcomes even in patients with increased tibial tubercle–trochlear groove (TT–TG) values. The primary aim of this study was to compare long-term clinical outcomes following isolated MPFL reconstruction in patients with increased TT-TG distance and those with normal TT-TG distance. Secondary aims were to compare the complication and recurrence rates between groups.
Methods
This prospective single-center study included 121 consecutive patients who underwent isolated MPFL reconstruction between 2011 and 2022. Patients were divided into 2 groups according to preoperative TT–TG distance: <20 mm (n = 90) and ≥20 mm (n = 31). Functional outcomes were assessed using the International Knee Documentation Committee (IKDC) score preoperatively and at a minimum follow-up of 24 months. Functional improvement (ΔIKDC) was calculated, and complication and recurrence rates were also collected. An adjusted analysis using analysis of covariance was performed to account for baseline differences in IKDC score.
Results
Postoperative IKDC scores were comparable between groups (80.1 ± 15.4 for TT–TG ≥20 mm vs 78.9 ± 15.3 for TT–TG <20 mm; p = 0.614). Functional improvement did not differ significantly between groups (ΔIKDC: 19.0 ± 17.3 vs 25.8 ± 18.9; p = 0.075). After adjustment for baseline IKDC score, no between-group difference was observed (adjusted mean difference −0.9 [−7.2; 5.3], p = 0.769). 2 complications occured in the TT–TG <20 mm group (1 case of postoperative stiffness not requiring arthrolysis, and 1 painful scar neuroma), and 1 case of stiffness requiring arthroscopic arthrolysis occured in the TT–TG ≥20 mm group. No recurrence of instability was reported in either group.
Conclusion
Isolated MPFL reconstruction provides excellent functional outcomes in patients with increased TT–TG distance, with no difference in functional improvement, complications, or recurrence rates compared with patients with normal TT-TG distance.
