Background:Patellofemoral instability commonly occurs during sports activities. The return to sports (RTS) rate for pediatric patients after bilateral medial patellofemoral ligament reconstruction (MPFLR) is unknown.Purpose/Hypothesis:The purpose of this study was to evaluate RTS outcomes for pediatric patients undergoing bilateral MPFLR. It was hypothesized that (1) fewer pediatric patients would RTS after bilateral MPFLR compared with unilateral MPFLR and that (2) for those in the bilateral cohort who were able to RTS, fewer patients would attain the same level of play as or higher level than the preinjury level.Study Design:Cohort study; Level of evidence, 3.Methods:We prospectively collected RTS data on retrospectively identified matched cohorts of patients aged ≤18 years who underwent unilateral and bilateral MPFLR. We matched each participant with bilateral MPFLR at a 1 to 2 ratio with a participant with unilateral MPFLR by concomitant procedure, age, and sex. Postoperative complications and preoperative imaging measurements were collected from medical records. Patient-reported outcomes were obtained using a current Single Assessment Numeric Evaluation score collected at the time of primary outcome data.Results:We matched 16 participants (mean age, 14 years) who underwent bilateral MPFLR to 32 participants (mean age, 14.3 years) in a corresponding unilateral MPFLR cohort. We found a significant decrease in RTS rates for pediatric patients after bilateral MPFLR when compared with unilateral MPFLR (69% vs 94%; P = .03). Among those who returned to sports, there was no difference in the level of play achieved. For participants who did not RTS or returned at a lower level of play after bilateral MPFLR, 57% cited fear of reinjury as the primary reason. There were no differences in postoperative complications or current Single Assessment Numeric Evaluation scores between cohorts. The bilateral cohort had a significantly higher Caton-Deschamps index compared with the unilateral cohort, although the absolute difference was small (1.3 vs 1.2; P = .005).Conclusion:We found that pediatric patients have a lower RTS rate after bilateral MPFLR when compared with a matched unilateral MPFLR cohort. No differences in the level of play were achieved among those who returned to sports. Fear of reinjury was a commonly cited reason for not returning to sports.

中文翻译：

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双侧与单侧内侧髌股韧带重建后儿科患者的运动恢复率

背景：髌股不稳常见于体育活动中。双侧内侧髌股韧带重建 (MPFLR) 后儿科患者的恢复运动 (RTS) 率尚不清楚。目的/假设：本研究的目的是评估接受双侧内侧髌股韧带重建 (MPFLR) 的儿科患者的 RTS 结局。假设 (1) 与单侧 MPFLR 相比，在双侧 MPFLR 后进行 RTS 的儿童患者较少，(2) 对于双侧队列中能够进行 RTS 的患者，达到与单侧 MPFLR 相同或更高水平的患者更少研究设计：队列研究；证据级别，3。方法：我们前瞻性地收集了回顾性确定的年龄≤18岁且接受单侧和双侧 MPFLR 的匹配患者队列的 RTS 数据。我们按照 1 比 2 的比例将每位患有双侧 MPFLR 的参与者与患有单侧 MPFLR 的参与者按照伴随手术、年龄和性别进行匹配。从病历中收集术后并发症和术前影像学测量结果。患者报告的结果是使用主要结果数据时收集的当前单一评估数字评估分数获得的。结果：我们将接受双侧 MPFLR 的 16 名参与者（平均年龄，14 岁）与 32 名参与者（平均年龄，14.3 岁）进行匹配。在相应的单侧 MPFLR 队列中。我们发现，与单侧 MPFLR 相比，接受双侧 MPFLR 治疗的儿科患者的 RTS 率显着降低（69% vs 94%；P = .03）。在那些重返体育运动的人中，所达到的比赛水平没有差异。对于在双侧 MPFLR 后未进行 RTS 或以较低水平回归的参与者，57% 的人认为担心再次受伤是主要原因。队列之间的术后并发症或当前单一评估数字评估分数没有差异。与单侧队列相比，双侧队列的 Caton-Deschamps 指数显着较高，尽管绝对差异较小（1.3 比 1.2；P = .005）。结论：我们发现，当双侧 MPFLR 术后儿童患者的 RTS 率较低时，与匹配的单侧 MPFLR 队列进行比较。那些重返体育运动的人的运动水平没有差异。担心再次受伤是不重返运动场的一个常见原因。