Minimum 6-Year Follow-Up of Arthroscopic Medial Reefing for Patellar Instability

INTRODUCTION: Purpose of this study was to evaluate the results of arthroscopic medial reefing for patellar instability at long term. MATERIALS-METHODS: 15 patients (16 knees) with patellar instability were consecutively treated by arthroscopic medial reefing between 2005- 2010. At final follow-up 11 patients (12 knees) were available to evaluate. Average age was 18,6 (range, 12-37 years). Average follow-up was 90 months (range, 71-115). History of patellar dislocation episode was reported by all patients. Arthroscopic medial reefing was applied through three standard portals. At least 3 sutures were tied according to medial laxity. Post-operatively all patients were allowed to bear weight on the operated leg immediately and full knee flexion was allowed by the third week. At last follow-up patients were evaluated according to the Tegner and Lysholm scales. Paired t test was used to detect the statistical differences and p<0.05 was considered significant. RESULTS: Two patients reported re-dislocations after the operation. Re-dislocation rate was 16.6% (2 in 12 knees). In general, patients reported significant improvement in pain, swelling, crepitus, and physical activity. The most common complaint was the anterior knee pain. The average pre and post-operative Tegner scores were 3.66 and 4.0, respectively. The average preoperative Lysholm score was 72 and postoperatively improved to 87.8 (p=0. 017). DISCUSSION: Arthroscopic medial reefing for patellar instability is a viable option for young patients with ligamentous insufficiency without major bony abnormalities. The most significant advantages are that the epiphyseal plates are protected in young patients, no skin incision applied, and no autografts are harvested.