Thank you, Sabrina. Appreciate the opportunity to present our work. I have no disclosures relating to this talk. So we know the medial patellofemoral ligament is the primary soft tissue restraint against lateral patella displacement. And surgery to address MPFL incompetence is the current gold standard for recurrent patellofemoral instability. However, controversy remains regarding the effectiveness of MPFL reconstruction in obese patients specifically defined as a BMI greater than 30. The purpose of our study was to compare outcomes, activity level, and complication rates of non-obese and obese patients undergoing MPFL reconstruction. Our hypothesis was that obese patients will have inferior outcomes, lower activity levels, and increased complications. This was a retrospective review of prospectively collected data of consecutive cohorts of patients undergoing soft tissue stabilization for recurrent patella instability. Surgery was performed by a single sports fellowship trained surgeon over a 7-year time frame. Presurgical and post-surgical PROs were collected, specifically Koos and Tegner scores. Complications requiring re-operation were recorded and recurrent instability. Patients undergoing concomitant bony procedures were excluded including osteotomy and or trochleoplasty. And results were analyzed statistically. Here's our demographics. We had 55 patients, female predominance. As you can see, the mean BMI in the obese group was 36.1 versus 24.5 in the group with the BMI under 30. Our preoperative patient-reported outcomes demonstrated no significant differences between the groups for Koos or Tegner scores. This is how we did our surgeries. We used a soft tissue allograft, the looped end in the femur, and then sutured into suture anchors on the patella at a resting length at 30 degrees, and then soft tissue stabilization of the native ligament over the top. Here you can see an exam under anesthesia. Lateral translation at 0 and 30 degrees. Demonstrating the location of these graphs. 55 patients, 6-month to 59-month follow-up. Did preoperative and postoperative outcome scores. Here's an example of a 6-month in the BMI less than 30 group. You can see her kind of functional starting at 6 months. Similarly we can see a patient in the BMI greater than 30 group. Similarly no apprehension or guarding, good range of motion and function at 6 months. Looking at our results for Koos, we saw there was improvement in all domains for both groups except for Koos quality of life for the BMI greater than 30 group. We can see that clearly here that that group was inferior for quality of life when compared to the BMI less than 30. Similarly the Tegner outcomes were superior for the BMI less than 30 group when compared to the obese cohort. Complications were low and comparable between the groups. There were no statistically significant differences and a very low number of complications overall. By way of discussion, the prior literature scant regarding the influence of BMI on outcomes in patella instability. There's been shown to be a negative association with subjective outcomes in some studies, no association with obesity and recurrent instability risk. Here we show that MPFL reconstruction is safe and effective in patients with a BMI above 30. There's clinically significant improvement in the majority of our subjective domains. When compared to those with BMI less than 30, obese patients have lower quality of life scores and activity levels without an increased rate of complications. And it's our hope that we can use this data to counsel our future patients effectively when undergoing this successful operation. I thank you very much for your attention.

MPFL reconstruction

obese patients

patient-reported outcomes

quality of life scores

subjective outcomes