Podium (Sports) 03

Time to ACL Reconstruction in the AFP: Does Delay in Surgery Increase Articular or Meniscal Injury

Christmon Evan P. Santos, M.D.
Jonathan C. Ronquillo, MD, FPOA (Research Adviser)

Patellofemoral knee pain (PKP) is a common complaint among adult individuals. It should be properly identified with a comprehensive history and physical examination. Lateral retinacular release (LRR) has shown its role in the treatment of PKP, as it addresses the imbalance of the extension mechanism due to the stronger lateral forces. An all arthroscopic release has shown its advantages with its minimal morbidity, reduced hospitalization stay and absence of interference with subsequent procedures. It is emphasized, however, that careful patient selection should be followed. As what makes it useful can also result in complications. This study aims to determine if there is a significant relief and improvement of the patients subjective scores post-release.

Consecutive patients who underwent arthroscopic LRR were included after thorough evaluation, and were prospectively followed up pre-operatively and postoperatively within the first and sixth months in a 2 year period. Validated Knee scoring systems (Kujala, Samsung Medical Center and Oxford knee) for patellofemoral pain and Visual Analogue Scale (VAS) were answered by the patients on each visit. A total of 5 patients were included (1 male:5 female), mean age of 56 years old (34-68). Preoperative Oxford knee 39.2(30-49), SMC function 48(27.5-67.5) and VAS 7.4(4-10) showed a significant improvement on the first month postoperative, with mean scores 28.3(21-34), 28.1(20-35) and 3.8(2-6) respectively. At 6 months postoperatively all of the scores, Kujala 74(43-92), Oxford Knee 24(15-41), SMC function 31.3(15-55), SMC pain 25(12-44) and VAS(0-6) have all shown significant improvement compared preoperatively. No complications were recorded. One patient subsequently underwent a total knee arthroplasty, LRR have provided a significant relief in the PKP and did not interfere with the subsequent procedure. In the short term, an all arthroscopic LRR is a simple, minimally invasive procedure with minimal morbidity that improves patient subjective scores, following a meticulous and careful patient selection.