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RECONSTRUCTION OF THE MEDIAL PATELLOFEMORAL LIGAMENT – A REVIEW OF TWENTY-FIVE CASES.



Abstract

Patellar instability is a common clinical problem affecting a young, active population. A large number of procedures have been described to treat patellar instability. We present the clinical results in a case series of 25 medial patellofemoral ligament reconstructions in 21 patients with up to 30 months follow-up (mean 7.3 months).

Reconstruction was performed using either the gracilis tendon (6 cases) or semitendinosus tendon (19 cases) autograft. At follow-up the Tegner activity scores, objective knee function, complications and reoperations were assessed.

No patella re-dislocations were observed. Five patients (20%) required a manipulation under anaesthetic but subsequently regained a satisfactory range of motion. Two patients (8%) had post operative complications. One patient developed a post operative infection which required a washout and one patient developed a neuroma related to the hamstring harvest site which was excised. Both subsequently returned to work with a full range of motion.

Medial patellofemoral reconstruction with both gracilis and semitendinosus tendon graft provided good postoperative patellar stability restoring the primary soft tissue restraint to pathological lateral patellar displacement.

Correspondence should be addressed to Major M Butler RAMC, 44 Theynes Croft, Long Ashton, Bristol, BS41 9NA, England.