Results of medial patellofemoral ligament reconstruction in the treatment of patellar dislocation.

Abstract

PURPOSE: The purpose of this study is to describe the technique of medial patellofemoral ligament reconstruction using autogenous hamstrings or autogenous fascia lata and report the results at a minimum 2-year follow-up. Type of Study: This study represents a case series. Patients with patellofemoral instability following patellar dislocation were restrospectively reviewed after being treated with medial patellofemoral ligament reconstruction. No concurrent control group was used. METHODS: Nineteen consecutive patients underwent medial patellofemoral repair or reconstruction in the treatment of patellar instability after patellar dislocation. The reconstructions were performed using autogenous gracilis and/or semitendinosus tendons or a strip of autogenous fascia lata. Fifteen patients were available for interview, examination, and radiographic evaluation, with a mean follow-up of 31.5 months. RESULTS: Subjectively, 10 knees had excellent results, 3 knees obtained good results, 1 knee had a fair result, and 1 knee had a poor result, for a total of 93% improvement overall. Using Fulkerson's functional knee score, 93% had good or excellent results. The average postoperative result on Kujala's score for anterior knee symptoms was 88 (range, 80-100). The Tegner activity level averaged 6.8 preinjury and 6.7 postoperatively. Radiographic evaluation showed significant improvements in the congruence angle by an average of 20 degrees (P =.0006), and in the lateral patellofemoral angle by an average of 10 degrees (P =.0003). CONCLUSIONS: Surgical reconstruction or repair of the medial patellofemoral ligament provides favorable results for the treatment of recurrent patellofemoral dislocations with regard to radiographic findings, patient satisfaction, and functional outcome.