ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
After MPFL reconstruction, femoral tunnel widening and migration increase with poor tunnel positioning and are related to poor clinical outcomes.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 10 citations in OpenAlex.
- Robotic-assisted vs. traditional medial patellofemoral ligament reconstruction: a comparative study of surgical precision and clinical outcomes.BMC surgery · 2025Article
- Femoral tunnel enlargement after medial patellofemoral ligament reconstruction is common and can be monitored using plain radiographs.Journal of clinical orthopaedics and trauma · 2025Article
- Current Concept Review: Medial Patellofemoral Ligament Reconstruction: From Rehabilitation to Return to Sport.International journal of sports physical therapy · 2025Article
- [Research progress on femoral attachment positioning during medial patellofemoral ligament reconstruction].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2024Review
- Promising results following derotational femoral osteotomy in patellofemoral instability with increased femoral anteversion: A systematic review on current indications, outcomes and complication rate.Journal of experimental orthopaedics · 2024Review
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Authors and funding
6 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIsolated MPFL reconstruction (iMPFLR) is increasingly used for the surgical treatment of treatment for recurrent patella dislocation. The purpose of this study was to evaluate the influence of tunnel widening and migration on clinical outcomes after iMPFL using a CT-scannographic analysis at 6 months postoperatively.
methodsOne hundred and sixty patients (91 females for 69 males) with an average age of 23 years [14-54] who underwent iMPFLR and had an evaluation scan at 6 months postoperatively were evaluated with a mean follow-up of 97 ± 89 months [12 to 166]. Functional International Knee Documentation Committee (IKDC) Score, Kujala score, and joint mobility were assessed preoperatively, at 6 months and at the latest follow-up. The IKDC and Kujala scores were expressed as the difference between pre- and postoperative scores (dIKDC and dKujala). The position of the femoral tunnel was assessed according to the Schöttle criteria on post-operative radiographic profiles. Tunnel widening (at three levels of measurement) and the migration of the center of the tunnel were studied on a CT-scan analysis at 6 months. Any correlation and regression between the evolution of the clinical scores and the measured scannographic parameters were investigated. The relationships between tunnel position and tunnel changes were also studied.
resultsBetween pre- and post-op, the IKDC (45 ± 13 to 80 ± 15, p < 0.001) and Kujala (55 ± 11 to 87 ± 12, p < 0.001) scores were significantly improved. Patients with tunnel changes had decreased clinical and functional results at 6 months post-op of an iMPFLR (p < 0.001). These changes in the femoral tunnel, evidenced by a tunnel entrance widening and migration of the tunnel center, were related to an initial malposition of the tunnel (p < 0.001).
conclusionIn iMPFLR, changes in the femoral tunnel, corresponding to dilatation and migration of the tunnel center, may occur. These changes are increased by the initial malpositioning of the femoral tunnel and are correlated with less good clinical and functional outcomes. LEVEL OF EVIDENCE: Level IV.
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