Good results are reported at 60-month follow-up after medial patello-femoral ligament reconstruction with fascia lata allograft for recurrent patellar dislocation.

Abstract

The aim of this study was to evaluate the efficacy of a new minimally invasive surgical technique for the reconstruction of the medial patellofemoral ligament (MPFL) with fascia lata allograft at 60-month minimum follow-up. Nineteen consecutive patients with chronic recurrent patellar dislocation were treated with MPFL reconstruction (53% isolate procedure, 47% in combination with other treatments). Seventeen patients (11 males/6 females) were available at 60-month follow-up and were clinically evaluated with validated scores. New episodes of patellar dislocation were considered failures. Radiographic and CT scan evaluation were executed preoperatively and at 60-month follow-up. All clinical scores improved from preoperative assessment to 24-month and 60-month follow-up (p < 0.001). Kujala score increased from 61.2 ± 18.1 to 86.7 ± 8.7 and 82.1 ± 10.2; KOOS increased from 54.5 ± 19 to 86.8 ± 9.6 and 84.3 ± 7.6; VAS for pain decreased from 5.1 ± 2.2 to 2.4 ± 1.5 and 1.7 ± 1.2; Tegner score increased from 3 [2-4] to 5 [3-8] and 5 [3-9], respectively. Objective IKDC improved too. No significant improvements between the 24-month and 60-month follow-up evaluations were recorded. Anterior knee pain was reported in two patients (12%). Treatment failure, a new episode of patellar dislocation 25months after the surgery, was observed in one patient (6%). Radiographic OA changes were not statistically significant between preop and 60-month follow-up. Tuberosity-troclear groove (TT-TG) distance and the patellar tilt angle were subjected to significant changes due to MPFL reconstruction and associated procedures. MPFL reconstruction with fascia lata allograft, alone or combined with other procedures, is a reliable treatment option for recurrent patellar dislocation with a success rate of 94% and without cartilage deterioration at 60-month follow-up. IV.