Summary

Simultaneous bilateral MPFL reconstruction is a safe approach to treat bilateral patellofemoral instability.

Abstract

Introduction- Recurrent patellar dislocation is often reported in bilateral knees in young active individuals. The medial patellofemoral ligament (MPFL) tear is the attributable cause behind many of them and warrants reconstruction of the ligament to stabilize the patellofemoral joint. This study aimed to compare the clinical and functional outcomes following simultaneous bilateral MPFL reconstruction (MPFL-R) procedures with the staged bilateral MPFL-R procedures (one knee at a time).
Methods- It was a retrospective matched cohort study. Out of a total of 58 patients of bilateral MPFL reconstruction, 22 patients had simultaneous bilateral MPFL reconstruction. From the remaining 36 patients of staged bilateral MPFL reconstruction, 22 were matched one-on-one to the simultaneous group of patients. Preoperative and the final postoperative Lysholm, Kujala, Tegner scores, and the range of knee movements of both groups were compared and analysed. The rate of complications and return to the theatre were noted in both groups.
Results- With a mean follow-up of 7.7 years (1.8 years to 12.3 years), there was a significant improvement in clinical parameters observed in both the groups (p<0.05). No significant difference could be found between the two groups in terms of the Lysholm, Kujala, and the range of knee movements (p> 0.05). The rate of complication was comparable in both the groups (p>0.05).
Conclusion- Simultaneous bilateral MPFL reconstruction surgery for bilateral patellofemoral joint instabilities leads to a clinical outcome that is not significantly different from that of the staged bilateral operative procedures done for the same. Also, there is no significant difference in the risk of complications following these two approaches.