Abstract
Introduction
There are numerous surgical techniques for medial patellofemoral ligament (MPFL) reconstruction. Problems with certain techniques include patellar fracture and re-rupture.
Aim
To investigate the functional outcomes of MPFL reconstructions performed using a free gracillis tendon graft, oblique medial patella tunnel and interference screw femoral fixation. Patients were selected for MPFL reconstruction if they had recurrent patellar dislocations, and with the use of clinical and radiographic evaluation.
Methods
A prospective case series of 31 consecutive knees in 28 patients underwent reconstruction of the MPFL using a free gracillis tendon graft, oblique medial patella tunnel and interference screw femoral fixation. Our primary outcome measure was the Kujala patellofemoral questionnaire. This was assessed preoperatively and postoperatively at 6 weeks and 3, 6, 9, 12, 18, 24 months and at final follow up. Secondary outcome measures included Fulkerson patellofemoral scores at the same time intervals, return to work, return to preoperative sport and complications.
Results
The median follow up time was 25 months (range 12 – 44 months). Kujala scores improved from 58 to 93 (p < 0.002) and Fulkerson scores improved from 58 to 95 (p < 0.002) pre- and postoperatively respectively. The median return to work was 8 weeks and return to preoperative sport was 11 weeks. There were 2 revisions as a result of trauma. There were no instances of patellar fracture in this case series.
Conclusions
MPFL reconstruction using a free gracillis tendon graft, oblique medial patella tunnel and interference screw femoral fixation appears to be an effective surgical intervention for patellar instability. This technique also reduces the risk of patellar fracture, a common shortcoming with many other techniques.
