Paper 52: Sex-Based Differences in Outcomes After MPFL Reconstruction

Abstract

Objectives:The purpose of the current study was to investigate whether pain, function, satisfaction, or return to play (RTP) differ between sexes post-operatively in those undergoing MPFL reconstruction for symptomatic patellar instability.Methods:A retrospective review of patients who underwent an MPFL reconstruction for symptomatic patellar instability was performed. Kujala score, Visual Analogue Scale (VAS), patient satisfaction, willingness to undergo surgery again, revisions, return to play (RTP) and MPFL-RSI score were evaluated. Clinical outcomes were compared between male and female patients. A p value of <0.05 was considered to be statistically significant.Results:Our study included 141 knees that underwent MPFLR, and the patient population was 69.5% female. Post-operatively, the mean VAS score at rest was 1.0 ± 1.7 in male patients and 1.6 ± 2.1 in female patients (p= 0.0963). The mean Kujala score was 88.8 ± 13.3 and 83.5 ± 16.1 for male and female patients respectively (p=0.1062). Overall, there was a significant difference in RTP, with male patients returning at higher rates (58.1% vs 33.3%, p = 0.0479). The mean VAS score during activity was significantly lower in male patients at 1.8 compared to female patients at 3 (p=0.016). MPFL-RSI-score was also significantly worse in female patients (69.5 vs 55.6, p = 0.0098). While female patients had slightly higher rates of recurrent subjective instability (14.3% vs 11.7%) and re-dislocation (2% vs 0%), the difference was not statistically significant (p = 0.6731 and 0.3490, respectively). Female patients demonstrated higher rates of additional surgery at long term follow up, though this difference was also not statistically significant (12.2% vs 4.6%, p = 0.1674).Conclusions:Female patients had worse clinical outcomes than males undergoing MPFLR for patellar instability, with significantly lower rates of RTP, VAS score during sport and MPFL-RSI scores with a trend towards lower Kujala score and VAS score.