Postoperative Bracing after Medial Patellofemoral Ligament Reconstruction.
J Knee Surg
; 37(9): 631-637, 2024 Jul.
Article
en En
| MEDLINE
| ID: mdl-38113911
ABSTRACT
It is unclear if bracing is necessary after isolated medial patellofemoral ligament reconstruction (MPFLr) for recurrent patellar instability. We hypothesize that patients who did not use a brace will have similar outcomes to those who were braced postoperatively. A retrospective review of patients who underwent isolated MPFLr from January 2015 to September 2020 at a single institution was performed. Those with less than 6 weeks of follow-up were excluded. The braced group was provided a hinged-knee brace postoperatively until the return of quadriceps function, which was determined by the treating physical therapist (brace, "B"; no brace, "NB"). Time to straight leg raise (SLR) without lag, recurrent instability, and total re-operations were determined. Univariate analysis and logistic regression were used to evaluate outcomes (statistical significance, p < 0.05). Overall, 229 isolated MPFLr were included (B 165 knees, 146 patients; NB 64 knees, 58 patients). Baseline demographics were similar (all p > 0.05). Median time to SLR without lag was shorter in the NB group (41 days [interquartile range [IQR] 20-47] vs. 44 days [IQR 35.5-88.3], p = 0.01), while return to sport times were equivalent (B 155 days [IQR 127.3-193.8] vs. NB 145 days [IQR 124-162], p = 0.31). Recurrent instability rates were not significantly different (B 12 knees [7.27%] vs. NB 1 knee [1.56%], p = 0.09), but the re-operation rate was higher in the brace group (20 knees [12.1%] vs. 0 [0%], p = 0.001). Regression analysis identified brace use (odds ratio [OR] 19.63, 95% confidence interval [CI] 1.43-269.40, p = 0.026) and female patients (OR 2.79, 95% CI 1.01-7.34, p = 0.049) to be associated with needing reoperation. Recurrent instability rates and return to sport times were similar between patients who did or did not use a hinged knee brace after isolated MPFLr. Re-operation rates were higher in the braced group. Retrospective Comparative Study, Level III.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Tirantes
/
Inestabilidad de la Articulación
Límite:
Adolescent
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Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
J Knee Surg
Asunto de la revista:
ORTOPEDIA
Año:
2024
Tipo del documento:
Article