Does Patient Age Matter for Medial Patellofemoral Ligament Reconstruction? Patients ≥30 Years of Age Compared With Younger Patients.

Background: Medial patellofemoral ligament (MPFL) reconstruction is a common procedure to treat recurrent patellar instability. Outcomes in older patients after this procedure have been less frequently reported in the literature. Hypothesis: Patients ≥30 years of age would demonstrate similar subsequent dislocation risk and patient-reported outcomes (PROs) after MPFL reconstruction to younger patients. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was undertaken to identify patients who underwent isolated MPFL reconstruction between 2008 and 2020. Patients were categorized into 2 groups based on age ≥30 years or <30 years at the time of surgery. Subsequent patellar dislocation risk and PROs (Knee injury and Osteoarthritis Outcome Score [KOOS], Norwich score, and Marx activity score) were compared between groups. PROs were compared controlling for anatomic and other demographic differences between groups. Results: A total of 228 patients underwent isolated MPFL reconstruction in the study period; 177 patients (78%) were assessed for subsequent patellar dislocation a minimum of 1 year postoperatively (median, 3.4 years). The study included 140 patients <30 years of age at surgery and 37 patients ≥30 years of age at surgery. Subsequent dislocation occurred in 9 patients (5.1%), including 7 patients <30 years (5.0% subsequent dislocation risk) and 2 patients ≥30 years (5.4% subsequent dislocation risk; Conclusion: Patients ≥30 years at the time of MPFL reconstruction demonstrate similar subsequent dislocation risk but poorer KOOS pain subscale and Marx activity values than patients <30 years at the time of MPFL reconstruction.