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J Knee Surg 2024; 37(09): 631-637
DOI: 10.1055/a-2232-4856
Original Article

Postoperative Bracing after Medial Patellofemoral Ligament Reconstruction

Andrew L. Schaver
1   Department of Orthopedic Surgery, Marshall University, Huntington, West Virginia
,
Meaghan A. Tranovich
2   Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa
,
Olivia C. O'Reilly
2   Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa
,
Matthew J. Bollier 
2   Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa
,
Kyle R. Duchman
2   Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa
,
Brian R. Wolf 
2   Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa
,
Robert W. Westermann
2   Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa
› Author Affiliations
Funding Research reported in this publication was supported by the National Center For Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002537.
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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

Keywords

patellar instability - MPFL reconstruction - bracing - rehabilitation

Note

This study was approved by UI IRB.




Publication History

Received: 09 March 2023

Accepted: 18 December 2023

Accepted Manuscript online:
19 December 2023

Article published online:
07 February 2024

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