Evaluation of combined arthroscopic lateral release and medial patellofemoral ligament reconstruction for the treatment of recurrent lateral patellar instability

Abstract

Background Different methods were used for the treatment of recurrent lateral patellar instability (LPI) of the knee and the combined arthroscopic lateral release and medial patellofemoral ligament (MPFL) reconstruction is an effective method of treatment. Aim This study aimed to evaluate the functional and radiological outcomes of treatment of recurrent LPI using combined arthroscopic lateral release and MPFL reconstruction. Patients and methods This prospective study was conducted on 12 patients, two male and 10 female, attending Saudi German Hospital in Saudi Arabia between March 2013 and October 2014, and the mean age was 26 years (range: 20–34) at the time of surgery. Patients with recurrent LPI confirmed by means of history, physical examination, and radiographic examinations were included in the study. Follow-up evaluation of the results after 1 year of surgery was carried out using Kujala score, Lysholm score, Tegner activity score, and the criteria of Crosby and Insall, and the rate of satisfaction was evaluated according to Nelitz. Results The congruence angle improved from 18.3±5.4° preoperatively to −5.0±0.4° at 1-year follow-up. The lateral patellar angle significantly improved from −7.5±4.2° preoperatively to 6.2±3.1° at 1-year follow-up. Moreover, the patellar tilt angle improved from 28.5±6.5° preoperatively to 8.2±0.7° at 1-year follow-up. The mean Kujala score increased significantly from 44.6±2.5 preoperatively to 92.4±3.6 points postoperatively (P Conclusion The double bundle graft technique used in this study for the reconstruction of MPFL provides proper anatomical position of the femoral fixation of the graft and gives stable tendon-to-bone fixation with early healing and offers a successful outcome that allows an early rehabilitation and return to full activity.