Medial Patellofemoral Ligament Reconstruction with Semi-Patellar Tunnel Fixation: Surgical Technique and Mid-Term Follow-Up.

Abstract

BackgroundThe present study aimed to describe a new safe and economical technique for medial patellofemoral ligament (MPFL) reconstruction with satisfactory clinical outcomes, and present the results of a four-year follow-up.Material/MethodsThirty-two patients with recurrent patella dislocation, who underwent MPFL reconstruction with two semi-patellar tunnels and hardware-free patellar fixation between 2011 and 2013, were included in the study. Patella stability was tested by an apprehension test preoperatively and at follow-up. Knee function was evaluated using the Kujala score, Lysholm score, and Crosby-Insall grading system. Patellar congruence angle and patellar tilt angle were measured using an axial computed tomography scan. Furthermore, objective feelings of patients and complications were recorded.ResultsThirty knees (30 patients) were followed for a minimum of 48 months. The apprehension test was positive in all patients preoperatively, but negative at follow-up. Kujala and Lysholm scores increased from 58.9±9.6 to 92.0±4.8 (p<0.001) and 53.3±5.6 to 91.6±3.5 (p<0.001), respectively, at the last follow-up. Seventeen patients were graded as excellent and 13 were graded as good by the Crosby-Insall grading system. The patellar congruence angle and patellar tilt angle also improved significantly. No patient experienced patellar re-dislocation, subluxation, or patella fracture. Most patients (93%) were satisfied with the surgery.ConclusionsMPFL reconstruction with two semi-patellar tunnels and hardware-free patellar fixation was described and the study observations indicated it was a safe and economical surgical procedure for recurrent patella dislocation with satisfactory results. It could be an alternative surgery method for patients with patella recurrent dislocation.