MPFL Repair for Acute Patella Dislocation

OBJECTIVES: To report on the findings of a single surgeon series of MPFL(medial patello-femoral ligament) repair in the treatment of first time patella dislocation. METHODS: 47 patients with 49 MPFL repairs for first time patella dislocation have been reviewed. All patients had pre-operative x-ray and MRI to define pathology, site of MPFL injury, presence of loose body/bodies, chondral injury etc. All patients underwent acute surgical repair at the site of injury to MPFL, as well as treatment of any secondary pathology. All patients were managed with a similar post-operative protocol of early weight bearing and range of motion utilizing a J-brace. Patients were contacted by phone or returned in person for completion of Kujula scores at time of reporting. RESULTS: 40 patients with 42 knees were available for final follow-up. Average follow up period is 3-9 yrs. Average Kujula score 89/100. 3 of 42 recurrent dislocation for rate of 6.1%. 1 deep infection. MPFL rupture site 28/49 at patella (57%), 15/49 at femur (30%), 3/49 both patella and femur (6.1%),1/49 mid-substance (2%), 2/49 not seen on MRI or at surgery ( 4%) Osteochondral loose body 28/49 (57%) 9/49 required additional oft tissue surgery CONCLUSION: This series describes the location of MPFL injury in first time patella dislocation. In this surgical series there is a high incidence of secondary injury. At 3.9yr follow up this series demonstrates a recurrent dislocation rate of 6.1%.