Medial patellofemoral ligament reconstruction with bioactive synthetic ligament is an option. A 3-year follow-up study.

Abstract

The purpose of this study was to evaluate mid-term follow-up results of medial patellofemoral ligament (MPFL) reconstruction using a bioactive synthetic ligament in the treatment of objective patellofemoral (PF) instability. Sixteen patients (18 knees) presenting with objective PF instability underwent a MPFL reconstruction, isolated or associated with other surgical procedures for PF stabilization. All patients were clinically evaluated at a minimum follow-up of 3 years. Kujala, subjective IKDC and KOOS scores were used to assess clinical outcome. Pre-operative and post-operative pain was quantified with VAS scale and the overall satisfaction graded according to Insall and Crosby. Although none of the patients in this series were involved in high-level sports activity because of patellofemoral instability, activity level pre-operatively and at follow-up were evaluated according to Tegner scale. No recurrence of dislocation was observed in this series. The overall satisfaction rate was 88.8%. Kujala score improved significantly from 57±8.4 to 84.3±10.2 points (p<.01). Both subjective IKDC (42.4±7.13 to 70.1±3.9) and KOOS (62.7±4.34 to 82.8±8.8) significantly improved from pre-operative evaluation (p<.01). VAS decreased from a mean pre-operative value of 2.5±1.6 to 1.4±1.5 at 3 years follow-up. Only one patient required revision debridement surgery for persistent medial epicondylar pain. Isolated or associated MPFL reconstruction with bioactive synthetic ligament is a valid option in surgical treatment of objective PF instability, with results at mid-term follow-up comparable to autologous graft, thus minimizing donor-site morbidity and associated complications. IV.