LONG-TERM OUTCOMES OF PATIENTS OPERATED FOR RECURRENT PATELLOFEMORAL INSTABILITY WITH AND WITHOUT PATELLAR CARTILAGE DEFECTS: A RETROSPECTIVE MATCHED COHORT STUDY

Shaival Dalal; Piyush Setia; Anindya Debnath; Randy Guro; Rahul Kotwal; Amit Chandratreya

doi:10.1302/1358-992X.2021.2.015

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LONG-TERM OUTCOMES OF PATIENTS OPERATED FOR RECURRENT PATELLOFEMORAL INSTABILITY WITH AND WITHOUT PATELLAR CARTILAGE DEFECTS: A RETROSPECTIVE MATCHED COHORT STUDY

The British Orthopaedic Research Society (BORS) Annual Meeting 2020, held online, 7–8 September 2020.

Shaival Dalal
Piyush Setia
Anindya Debnath
Randy Guro
Rahul Kotwal
Amit Chandratreya

LONG-TERM OUTCOMES OF PATIENTS OPERATED FOR RECURRENT PATELLOFEMORAL INSTABILITY WITH AND WITHOUT PATELLAR CARTILAGE DEFECTS: A RETROSPECTIVE MATCHED COHORT STUDY

Dalal S, Setia P, Debnath A, Guro R, Kotwal R, Chandratreya A. LONG-TERM OUTCOMES OF PATIENTS OPERATED FOR RECURRENT PATELLOFEMORAL INSTABILITY WITH AND WITHOUT PATELLAR CARTILAGE DEFECTS: A RETROSPECTIVE MATCHED COHORT STUDY. Orthop Procs. 2021;103-B(SUPP_2):15-15. doi:10.1302/1358-992X.2021.2.015

Dalal, Shaival, et al. “LONG-TERM OUTCOMES OF PATIENTS OPERATED FOR RECURRENT PATELLOFEMORAL INSTABILITY WITH AND WITHOUT PATELLAR CARTILAGE DEFECTS: A RETROSPECTIVE MATCHED COHORT STUDY.” Orthopaedic Proceedings, vol. 103-B, no. SUPP_2, 2021, pp. 15-15., https://doi.org/10.1302/1358-992X.2021.2.015

Dalal, S., Setia, P., Debnath, A., Guro, R., Kotwal, R., & Chandratreya, A. (2021). LONG-TERM OUTCOMES OF PATIENTS OPERATED FOR RECURRENT PATELLOFEMORAL INSTABILITY WITH AND WITHOUT PATELLAR CARTILAGE DEFECTS: A RETROSPECTIVE MATCHED COHORT STUDY. Orthopaedic Proceedings, 103-B(SUPP_2), 15-15. https://doi.org/10.1302/1358-992X.2021.2.015

Dalal, S., Setia, P., Debnath, A., Guro, R., Kotwal, R. and Chandratreya, A. (2021) “LONG-TERM OUTCOMES OF PATIENTS OPERATED FOR RECURRENT PATELLOFEMORAL INSTABILITY WITH AND WITHOUT PATELLAR CARTILAGE DEFECTS: A RETROSPECTIVE MATCHED COHORT STUDY.” Orthopaedic Proceedings, 103-B(SUPP_2), pp. 15-15. Available at: https://doi.org/10.1302/1358-992X.2021.2.015

Dalal, Shaival, Piyush Setia, Anindya Debnath, Randy Guro, Rahul Kotwal, and Amit Chandratreya. “LONG-TERM OUTCOMES OF PATIENTS OPERATED FOR RECURRENT PATELLOFEMORAL INSTABILITY WITH AND WITHOUT PATELLAR CARTILAGE DEFECTS: A RETROSPECTIVE MATCHED COHORT STUDY.” Orthopaedic Proceedings 103-B, no. SUPP_2 (2021): 15-15. https://doi.org/10.1302/1358-992X.2021.2.015

Dalal S, Setia P, Debnath A, Guro R, Kotwal R, Chandratreya A. LONG-TERM OUTCOMES OF PATIENTS OPERATED FOR RECURRENT PATELLOFEMORAL INSTABILITY WITH AND WITHOUT PATELLAR CARTILAGE DEFECTS: A RETROSPECTIVE MATCHED COHORT STUDY. Orthop Procs. 2021 Mar 1;103-B(SUPP_2):15-15. https://doi.org/10.1302/1358-992X.2021.2.015

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Abstract

Background

Recurrent patellar dislocation in combination with cartilage injures are difficult injuries to treat with confounding pathways of treatment. The aim of this study is to compare the clinical and functional outcomes of patients operated for patellofemoral instability with and without cartilage defects.

Methods

82 patients (mean age-28.8 years) with recurrent patellar dislocations, who underwent soft-tissue or bony procedures, were divided into 2 matched groups (age, sex, follow-up and type of procedure) of 41 each based on the presence or absence of cartilage defects in patella. Chondroplasty, microfracture, osteochondral fixation or AMIC-type procedures were done depending on the nature of cartilage injury. Lysholm, Kujala, Tegner and Subjective Knee scores of both groups were compared and analysed. Complications and return to theatre were noted.

Results

With a mean follow-up of 8 years (2 years-12.3 years), there was a significant improvement observed in all the mean post-operative Patient Reported Outcome Measures (p<0.05) of both the groups, as compared to the pre-operative scores. Comparing the 2 groups, post-operative Lysholm, Kujala and Subjective knee scores were significantly higher in patients operated without cartilage defects (p<0.05). 3 patients operated for PFJ instability with cartilage defects had to undergo patellofemoral replacement in the long term. Odds ratio for developing complications is 2.6 for patients operated with cartilage defects.

Conclusion

Although there is a significant improvement in the long term outcome scores of patients operated for recurrent patellar dislocation with cartilage defects, the results are significantly inferior as compared to those without cartilage defects, along with a higher risk of developing complications and returning to theatre.

Declaration of Interest

(b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.