Medial patellofemoral ligament reconstruction technique

Abstract

Backgroud Recurrent patellar dislocation is a challenging medical problem for both the patient and the surgeon because of its multifactorial etiology.The medial patellofemoral ligament (MPFL) extends between the superomedial border of the patella and the anterior aspect of the medial femoral epicondyle in layer 2 of the medial soft tissue structures In the last decade, there have been many techniques for reconstruction of the MPFL. All techniques rely on supplying tendinous reconstruct from the medial border of the patella to the adductor tubercle, using different tendonsThe aim of this study was to describe the technique of reconstruction of MPFL and evaluation of the results using transverse holes in the patella and femoral interference screw. Patients and methods From January 2013 to April 2016, 20 cases underwent isolated MPFL reconstruction, after institutional ethics approval and informed consent was obtained from every patient. Out of the operated 20 cases, there were 12 females and eight males, with an average age of 24 years. Average age at the first dislocation episode was 21±2 years. Mean follow-up is about 18.3 months (range: 9–28), a mean of 4.8 dislocations per patient (range: 3–16 times). All were caused by either trauma or physical activity (14 trauma, six physical activity). Results All cases regained full range of motion; the apprehension sign dropped from 90% preoperative in 18 cases to 15% postoperative (only three cases). The glide test dropped from 100to 0% in follow-up. Mean Lysholm score improved significantly from 58%±3 to 93%±4. Conclusion MPFL reconstruction for treatment of recurrent patellar dislocation with a gracilis tendon autograft, using transverse holes in the patella and a screw for femoral fixation, showed good results at short-term follow-up