Evidence map›Paper›PMID 34491379›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022

Revision surgery for failed medial patellofemoral ligament reconstruction results in better disease-specific outcome scores when performed for recurrent instability than for patellofemoral pain or limited range of motion.

Felix Zimmermann, Danko D Milinkovic, Juliane Börtlein, Peter Balcarek

Abstract read
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In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Patellofemoral Instability in the Pediatric Population.Current reviews in musculoskeletal medicine · 2023
    Review
  5. Article
  6. Article
  7. Article
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Felix ZimmermannBG Klinik Ludwigshafen, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen am Rhein, Germany. felix.o.zimmermann@googlemail.com.
Danko D MilinkovicArcus Sportklinik, Pforzheim, Germany.
Juliane BörtleinArcus Sportklinik, Pforzheim, Germany.
Peter BalcarekArcus Sportklinik, Pforzheim, Germany.
ARCUS Sports Clinic · DEKlinikum Ludwigshafen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMedial patellofemoral ligament reconstruction (MPFL-R) is an important treatment for recurrent patellar instability. Although complications such as redislocation, patellofemoral pain (PFP) and restricted knee range of motion have been reported, few studies have investigated the results of revision surgery for failed MPFL-R. Thus, the aim of this study was to determine the results of the tailored revision surgery after considering the cause of the reconstruction failure. MATERIALS AND

methodsBetween 2015 and 2019, 28 patients (male/female 9/19; age 26.2 ± 6.4 years) underwent revision surgery for failed MPFL-R. The patients were grouped into the "recurrent instability" (SG1) group and "PFP" and/or "restricted range of motion" (SG2) group. Preoperatively, the clinical data, anatomical risk factor profile, and position of the femoral MPFL tunnel were determined for each patient. The Banff Patella Instability Instrument 2.0 (BPII 2.0) and numerical analogue scale (NAS 0-10) were administered preoperatively and at the final follow-up for the subjective assessment of the PFP and knee joint function.

resultsOverall, the BPII 2.0 score improved from 28.8 ± 16.6 points preoperatively to 68.0 ± 22.7 points (p < 0.0001) postoperatively. SG1 exhibited an increase in the BPII 2.0 score from 28.9 ± 20.2 points to 75.7 ± 23 points (p < 0.0001). PFP decreased from 6.8 ± 2.4 to 1.6 ± 1.9 (p < 0.0001), while the knee joint function increased from 4.3 ± 2.5 to 8.8 ± 1.6 (p < 0.0001). In SG2, the BPII 2.0 score increased from 28.7 ± 12.6 points preoperatively to 57.7 ± 19.7 points (p = 0.0002) postoperatively and was thus significantly lower than that in SG1 (p = 0.038). The intensity of PFP decreased from 6.6 ± 3.0 preoperatively to 2.1 ± 1.9 postoperatively (p = 0.0006), while the subjective knee joint function improved from 3.2 ± 1.4 preoperatively to 7.6 ± 2.3 postoperatively (p < 0.0001). The differences between the groups were not significant.

conclusionTailored revision surgery for failed MPFL-R significantly improves the patient-reported disease-specific quality of life. The study results indicate that patients undergoing revision surgery as a consequence of patellar redislocation appear to benefit more from revision surgery than those patients undergoing revision due to postoperative PFP and/or a limited knee joint range of motion. LEVEL OF EVIDENCE: Level IV.

Indexed as

Joint InstabilityPatellar DislocationPatellofemoral JointPatellofemoral Pain SyndromeAdultFemaleHumansKnee JointLigaments, ArticularMalePatellaQuality of LifeRange of Motion, ArticularReoperationYoung AdultComplicationMPFLPatellar instabilityRevision surgery

Identifiers

PMID34491379
OpenAlexW3198421852

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.