Arthroscopy, sports medicine, and rehabilitation
Return-to-Sport Assessment After Medial Patellofemoral Ligament Reconstruction Shows Substantial Variability in Objective Criteria
By Kang L, Ward GH, Hevesi M and 5 others.
Abstract
Purpose
To evaluate objective return-to-sport (RTS) outcomes and limb symmetry index (LSI) data after primary medial patellofemoral ligament reconstruction (MPFLR) in patients with patellar instability.
Methods
A systematic search of Scopus, PubMed, CINAHL, and Embase (2000-2024) identified studies reporting RTS outcomes and LSI-based performance testing in patients undergoing primary MPFLR. Clinical and observational studies reporting objective metrics such as isokinetic strength and hop testing were included.
Results
Six studies including 243 patients (64% women, mean age 19.4 years) undergoing primary MPFLR were included. Several studies included patients undergoing concomitant bone procedures (41%), such as tibial tubercle osteotomy or trochleoplasty. Objective RTS testing commonly included isokinetic strength (4 studies), hop testing (3 studies), and Y-Balance testing (2 studies). Follow-up testing ranged from 6 to 8 months postoperatively. Reported LSI values ranged from 83% to 94% for isokinetic flexion, 70% to 96% for isokinetic extension, 85% to 93% for single hop, and 90% to 97% for triple hop. Time to RTS ranged from 6.1 to 8.1 months across studies, with RTS rates from 85% to 100%. However, only 14% to 40% of patients met all study-specific RTS criteria when reported. Testing protocols and thresholds varied across studies, contributing to heterogeneity in outcomes.