Return to sports and short-term follow-up of 101 cases of medial patellofemoral ligament reconstruction using gracilis tendon autograft in children and adolescents.

Abstract

An acute patellofemoral dislocation is the most common acute knee injury in children. Recent studies suggest up to 40% of immature patients may develop recurrent instability. MPFL reconstruction has become a mainstay for the treatment of patellofemoral instability. Aim of the recent study is to show our experiences of MPFL reconstruction in patellar instability in immature patients using a gracilis autograft in respect to return to sport, growth plate disorders and short-term results. A total of 101 patients (50 females, 51 males) were included in this retrospective study. Mean age at time of operation was 14.8 ± 1.6years. Primary outcome measures included patient satisfaction, Kujala score, recurrent instability, return to normal activity, return to sports, clinical leg axis and complications. Mann-Whitney U test was used for statistical analysis and alpha was set at p < 0.05 to declare significance. At a mean follow-up of 32.0 ± 12.1months 90/101 patients could be followed-up. 84% of all patients were satisfied or very satisfied with the result at latest follow-up. 86.6% of all patients were able to return to sports, 2.3% had a relevant deviation of the clinical leg axis, but symmetrical. In sum complication rate was 2.9%. Redislocation rate was 0.9% (1/101). Kujala Score improved significantly from 47.1 preoperatively to 85.3 postoperatively (p < 0.01). Anatomic MPFL reconstruction using gracilis tendon allograft tissue is a safe procedure in children and adolescents with low risk of recurrent instability.