Combined Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Transfer Results at a Follow-Up of 2 years.

Abstract

There is limited data on the effectiveness of combined medial patellofemoral ligament (MPFL) reconstruction and tibial tubercle transfer (TTT) in patients with patella instability. The aim of our study was to analyze the functional outcome in patients treated with MPFL reconstruction and TTT. Between July 2008 and April 2013, 18 patients (21 knees) underwent combined MPFL reconstruction and TTT; 15 patients (16 knees) with a mean age of 24 years (16-41) had a mean follow-up of 30 months (26-55). There was significant improvement in outcome scores in 12 out of 15 patients. KOOS score improved from 68.25 (44-93.9) to 77.05 (48.8-96.4) and KUJALA score improved from 63.3 (41-88) to 78.06 (45-99). Nine patients achieved at least a preinstability level of activity. Out of these nine patients, four had activity level better than the preinstability level. The remaining six patients had a lower activity level than preinstability level (2-lack of confidence and 4-lifestyle modification). Fourteen patients were satisfied and happy to recommend this procedure. There were three postoperative complications, with two cases of stiffness and one case of nonunion of the tibial tuberosity. Thus, the restoration of tibial tubercle to trochlear groove distance, patella height, and MPFL reconstruction yields good results in carefully selected patients.