Medial Patellofemoral Ligament Reconstruction: Clinical Outcomes at a Minimum Three-Year Follow-up

OBJECTIVES: Recurrent patellofemoral dislocation is usually a multifactorial pathology. Different surgical techniques have been described according to the etiology of dislocation. In absence of a severe malalignment or an anatomical patellofemoral dysplasia, reconstruction of Medial Patello-femoral Ligament (MPFL) can restore the normal tracking of the patella, avoiding lateral excursion. The purpose of this study was to evaluate clinical results and complications in patients who underwent a MPFL reconstruction. METHODS: We retrospectively evaluated 19 patients who underwent an anatomic MPFL reconstruction using autologous semitendinosus graft between 2007 and 2012. Exclusion criteria were patients with less than three years of follow-up and those with an associated procedure such as distal realignment or trochleoplasty. Clinical outcomes were measured using Kujala score and return to sport rate. We registered the postoperative complications and recurrence rate. RESULTS: Nine patients were men and 10 women with a mean age of 25 years. Average follow-up was 5.8 years. Nine patients (47.4%) returned to their previous sport level, 8 (42.1%) changed to another sport or decreased their level and 2 (10.5%) were unable to practice any sports at all. Kujala score improvement was from 62.8 preoperative to 88.8 postoperative. One patient decreased the Kujala score. Eighty-nine percent of patients were satisfied with their outcome. One patient had a patellar fracture and four developed an arthrofibrosis and required mobilization under anesthesia. No recurrences were registered. CONCLUSION: Isolated MPFL reconstruction for recurrent patellofemoral dislocation is an effective alternative in absence of severe malalignment or anatomical dysplasia. Although no recurrences where registered at minimum 3-year follow-up, almost half of the patients were not able to return to their previous sport level.