Abstract

BackgroundThe purpose of this study was to retrospectively analyze the clinical outcomes of patients with recurrent patellar dislocation who underwent arthroscopic medial patellofemoral ligament (MPFL) reconstruction using gracilis tendon autograft and a modified double-patellar tunnel method. We hypothesized that our modified method would provide good clinical outcomes.MethodsPatients who underwent arthroscopic MPFL reconstruction with autograft gracilis tendon and modified double-patellar tunnels technique for recurrent patellar dislocation and were followed up for a minimum of 5 years were identified, and the clinical and follow-up data were retrospectively analyzed. Preoperatively, joint hypermobility was assessed with the Beighton score. The Insall–Salvati ratio, TT–TG distance, and Q angle were measured on radiographic images. Patient-reported outcomes including the Kujala, Lysholm, and Tegner scores were collected preoperatively and postoperatively. Patient satisfaction was assessed at the end of 5 years. Complications and recurrent dislocation occurring after surgery were recorded.ResultsA total of 79 patients (94 knees) were enrolled; of these, 13 (16.5%) were lost to follow-up. The data of 66 patients (80 knees) were available for final analysis. Mean age at surgery was 21.3 ± 7.8 years. Mean follow-up time was 66.1 ± 5.5 months (range, 60–78 months). Postoperative patient-reported outcome was not associated with Beighton score, Insall–Salvati ratio, or TT–TG distance. Q angle was negatively correlated to Kujala scores and Lysholm scores. Severity of trochlear dysplasia was not associated with postoperative patient-reported outcome. The mean Kujala score increased from 69.4 ± 7.9 to 96.1 ± 1.9, the mean Tegner score increased from 3.1 ± 1.3 to 5.9 ± 1.3, and the mean Lysholm score increased from 73.5 ± 14.6 to 95.3 ± 3.4. Two patients experienced recurrent patellar dislocation during follow-up.ConclusionsMPFL reconstruction using autologous gracilis tendon under arthroscopy appears to be a reliable and safe method for treating recurrent patellar dislocation.Level of evidenceLevel IV.

Highlights

  • Acute patellar dislocation is a common injury, especially among adolescents, and is usually related to sports and physical activities [1]

  • The purpose of this study was to evaluate outcomes in patients with recurrent patellar dislocation treated with arthroscopic medial patellofemoral ligament (MPFL) reconstruction using autograft gracilis tendon and a modified double-patellar tunnel method

  • Patients A total of 79 patients who underwent MPFL reconstruction using autograft gracilis tendon with modified two patellar tunnels technique between January 2012 and June 2013 were included in this retrospective study

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Summary

Introduction

Acute patellar dislocation is a common injury, especially among adolescents, and is usually related to sports and physical activities [1]. The MPFL is composed of an inferior-straight bundle at the medial aspect of the patella and a superior-oblique bundle at the superiormedial aspect of patella [12] Because of this doublebundle structure of the MPFL, a patellar doubletunnel approach is recommended to achieve anatomical reconstruction [13, 14]. The purpose of this study was to retrospectively analyze the clinical outcomes of patients with recurrent patellar dislocation who underwent arthroscopic medial patellofemoral ligament (MPFL) reconstruction using gracilis tendon autograft and a modified double-patellar tunnel method. We hypothesized that our modified method would provide good clinical outcomes

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