SYNTHETIC VERSUS AUTOLOGOUS RECONSTRUCTION (SYN-VAR) RANDOMIZED CONTROLLED TRIAL OF THE MEDIAL PATELLOFEMORAL LIGAMENT

Abstract

AbstractIntroductionThe Syn-VAR RCT is the first of its kind comparing hamstrings autograft v synthetic neoligament for MPFL reconstruction.Our aim is to evaluate short and long term patient related outcomes measures (PROMs) following synthetic / autologous MPFL reconstruction in a heterogenous cohort of patients with recurrent patellar instability.Method20 patients meeting inclusion criteria were recruited and randomised. Standardised surgery was performed by a single surgeon in Altnagelvin Hospital with data collected over 3 years from 2016. Kujala score was the primary outcome measure with data captured preoperatively and 12 weeks/2 years postoperatively. Secondary outcomes included four other validated scores and complications including Norwich Patellar Instability, Lysholm, IKDC and BanffResults20 patients with an average age of 19 included 9 females and 11 males. At 12 weeks and 2 years Kujala improvement in the hamstring group was 18 and 32 (both p<0.05) compared to the synthetic group where the increase was 2 and 20 (p<0.05). All secondary score improvements at 2 years were significant (p<0.05) with no difference in any score at all time intervals when comparing both groups (p<0.05).DiscussionOur RCT validates the non-inferiority of synthetic MPFL reconstruction as a treatment for restoring patellar stability in a small heterogenous group with positive long term data and minimal morbidity. With no hamstring harvesting offering a reduction in theatre time with this offers a safe, efficient and viable alternative with reduced morbidity.