Medial Patellofemoral Ligament Reconstruction with Semi-Patellar Tunnel Fixation: Surgical Technique and Mid-Term Follow-Up

BACKGROUND: The present study aimed to describe a new safe and economical technique for medial patellofemoral ligament (MPFL) reconstruction with satisfactory clinical outcomes, and present the results of a four-year follow-up. MATERIAL/METHODS: Thirty-two patients with recurrent patella dislocation, who underwent MPFL reconstruction with two semi-patellar tunnels and hardware-free patellar fixation between 2011 and 2013, were included in the study. Patella stability was tested by an apprehension test preoperatively and at follow-up. Knee function was evaluated using the Kujala score, Lysholm score, and Crosby-Insall grading system. Patellar congruence angle and patellar tilt angle were measured using an axial computed tomography scan. Furthermore, objective feelings of patients and complications were recorded. RESULTS: Thirty knees (30 patients) were followed for a minimum of 48 months. The apprehension test was positive in all patients preoperatively, but negative at follow-up. Kujala and Lysholm scores increased from 58.9±9.6 to 92.0±4.8 (p<0.001) and 53.3±5.6 to 91.6±3.5 (p<0.001), respectively, at the last follow-up. Seventeen patients were graded as excellent and 13 were graded as good by the Crosby-Insall grading system. The patellar congruence angle and patellar tilt angle also improved significantly. No patient experienced patellar re-dislocation, subluxation, or patella fracture. Most patients (93%) were satisfied with the surgery. CONCLUSIONS: MPFL reconstruction with two semi-patellar tunnels and hardware-free patellar fixation was described and the study observations indicated it was a safe and economical surgical procedure for recurrent patella dislocation with satisfactory results. It could be an alternative surgery method for patients with patella recurrent dislocation.