Casey Tingle , 2025-05-15 14:51:00
Key takeaways:
- Patients returned to sport earlier and at a higher rate at the same or higher level with isolated MPFL reconstruction.
- Isolated and combined MPFL reconstruction led to similar reasons not to return to sport.
WASHINGTON — Results presented here showed medial patellofemoral ligament reconstruction with or without tibial tubercle osteotomy yielded high return-to-sports rates.
However, patients were able to return to sport sooner and at the same or higher level with an isolated procedure.
“Patients undergoing [tibial tubercle osteotomy] have some underlying cartilage damage, have a history of multiple dislocations and they have a higher number of concomitant procedures performed. These factors could lead to a more difficult recovery after their surgery,” Michelle E. Kew, MD, orthopedic surgeon specializing in shoulder and sports medicine surgery at Hospital for Special Surgery, told Healio. “We showed that isolated MPFL reconstruction did return back to sport sooner at the same or higher level, but both groups had great return-to-sport rates as a baseline across the study.”
Kew and colleagues retrospectively collected patient demographics, surgical data, radiographic data and redislocation rates among 178 patients with patellar instability treated with MPFL reconstruction either with (n = 59) or without (n = 119) tibial tubercle osteotomy (TTO). Researchers collected Kujala, KOOS and IKDC scores, and contacted patients regarding return to sport, level of return and any new injuries sustained.
In her presentation at the Arthroscopy Association of North America Annual Meeting, Kew said recurrent instability did not differ between the isolated and combined groups.
“We did find that patients undergoing an isolated MPFL returned significantly sooner than those undergoing a TTO to the tune of 9 months vs. about 13 months,” Kew said. “They also returned to the same or higher level of sport more often than those undergoing combined [surgery], 85% vs. 66%.”
However, when asked why patients did not return to sport, Kew said there were no differences in the reasons between the two groups.
“Some patients lost interest in the sport. Some of them reported concern about their knee, and kinesiophobia was an important factor they all mentioned as well,” Kew said.
In the future, Kew said orthopedic research will focus on individualizing return to sport and patient care across the treatment timeline.
“Safe return to sport is the ultimate goal after any procedure,” Kew told Healio. “The next frontier is going to be individualizing return to sport across patients and across disciplines.”
For more information:
Michelle E. Kew, MD, wishes to be contacted through mediarelations@hss.edu.
Sources/Disclosures
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Kew ME, et al. Return-to-sport following MPFLR vs. combined MPFLR and TTO for recurrent patellar instability. Presented at: Arthroscopy Association of North America Annual Meeting; May 8-10, 2025; Washington, D.C.
Disclosures:
Kew reports no relevant financial disclosures.
