Return to Sport After Patellofemoral Realignment and Stabilization Procedures

Abstract

This chapter summarizes data in the current literature regarding return to sports (RTS) after patellofemoral realignment surgery from 52 studies encompassing 1892 patients. There were 1408 patients in 36 studies that underwent medial patellofemoral ligament (MPFL) reconstruction or repair and 484 patients in 16 studies that underwent a variety of patellar proximal and/or distal realignment procedures that did not involve MPFL reconstruction or repair (such as Fulkerson and Elmslie-Trillat). Following MPFL reconstruction, a mean of 70% of patients returned to preinjury sports activity levels, a mean of 83% returned to any sport, and the approximate mean postoperative Tegner score was 5.2 points. After other proximal/distal procedures, the mean values for return to preinjury sports (provided in only 5 studies) ranged from 22% to 97% and the mean postoperative Tegner score was 4.1 points. The mean time patients were usually allowed to RTS was provided in 28 studies and varied from 3 to 9 months postoperatively. Almost no objective criteria were provided to determine when patients could be safely released to either sports-specific training or unrestricted athletic activities. The failure rates were <10% in the majority of studies. The Cincinnati Sports Medicine and Orthopedic Center postoperative rehabilitation program and return to sport criteria are provided.