Midterm results of combined patellofemoral and patellotibial ligaments reconstruction in recurrent patellar dislocation.

Abstract

To report the midterm results of mini-invasive anatomical no hardware combined reconstruction of the medial patellofemoral ligament (MPFL) and medial patellotibial (MPTL) using single semitendinosus tendon autograft. A prospective study was performed on 33 cases with recurrent patellar dislocation treated with combined MPFL and MPTL reconstruction by a described Relay Technique. Evaluation was focusing on return to previous level of activity, range of motion, apprehension, overall patient satisfaction and scoring with VAS, Cincinnati, Kujala's, Lysholm scores. Radiological evaluation was based on congruence and tilting angles. Four cases were lost to follow-up and excluded from the study, so the study included 29 patients. The mean VAS had improved from 6.3 to 1.8. Cincinnati score increased from 50 ± 7.1 (range, 38-60) to 88 ± 6 (range, 76-100). The mean Kujala score increased from 36.6 ± 6 (range, 22-48) to 90.6 ± 7 (range, 78-100). The mean Lysholm score increased from 51.9 ± 4.7 (range, 42-59) to 89.5 ± 5.6 (range, 78-98). The congruence angle improved from 11.93° to -6.48°, and the patellar tilt angle from 10.9° to 2.45°. All improvements were statistically significant. Only one case reported unsatisfaction, and 96.4 % were satisfied and returned to previous activity. No single recurrence was reported. Combined anatomical MPFL and MPTL reconstruction with semitendinosus (ST) autograft using mini-invasive Relay Technique is safe, and its midterm results show significant clinical and radiological improvements with 96.4 % patient satisfaction and nil rate of recurrence.