Treatment of patellofemoral instability in adolescent by anatomical double-bundle medial patellofemoral ligament reconstruction with double suture anchor technique

Abstract

To explore the clinical outcomes of anatomical double-bundle medial patellofemoral ligament (MPFL) reconstruction with double suture anchor technique in treating patellofemoral instability in adolescent. Methods: Twenty-five young people with patellofemoral instability (25 knees) in our department from January 2013 to December 2014 were enrolled for this study. All patients were performed anatomical double-bundle MPFL reconstruction with arthroscopic-assisted suture anchors technique in the patella, and fixed in the femoral socket with absorbable interference screw. All patients are evaluated by different methods, including patient's satisfaction, patellar apprehension test, recurrent subluxation/dislocation, CT assessment of bone tunnel and patellar tilt angle. Lysholm scores, Tegner scores and Kujala scores were recorded at the final follow-up. Results: The mean follow-up was 24 (range 20-40) months. All cases were observed in negative patellar apprehension test. Infection, recurrent subluxation/dislocation and patellar fracture were not found at the last follow-up. CT results demonstrated that the tunnel position were good. The patellar tilt angle was decreased from 21.6°±2.3° to 10.5°±1.6° (P<0.05); the Lysholm scores was increased from 51.7±5.3 to 93.8±6.5 (P<0.05). Tegner scores was increased from 4.1±1.1 to 5.5±0.6 (P<0.05). Kujala scores was increased from 53.5±6.4 to 94.6±4.3 (P<0.05). Conclusion: Arthroscopic-assisted anatomical double-bundle MPFL reconstruction with the suture anchors technique is a safe, minimal invasive and effective surgical option for treating patellofemoral instability in adolescent.