Summary

MPFL reconstruction using a superficial quadriceps tendon autograft in recurrent patellar dislocation offers satisfactory functional results

Abstract

Purpose

This study aims to assess the functional outcomes of patients undergoing MPFL reconstruction using superficial quadriceps tendon and also assess the postoperative complication and patient's satisfaction level.

Methods

We retrospectively reviewed 33 patients (15 males, 18 females) with an average age of 19 years with recurrent patellar dislocation, operated from August 2015 to January 2018. We used the same technique as Goyal et al. [1] and Fink et al. [2] described. This technique requires only a single bioabsorbable interference screw for the fixation of graft in the femoral side. whereas, only a few stitches with ethibond suture are required in the patellar side. Inclusion criteria of the study were patients with a recurrent patellar dislocation undergoing MPFL reconstruction with a minimum follow-up of 1 year. Exclusion criteria of the study were: (1) associated ligamentous injuries of the knee joint, and (2) previous history of bony correction along with MPFL reconstruction. The clinical evaluation was performed using Kujala knee score [3] and visual analogue scale (VAS) scores. Postoperative satisfaction level was performed using a self-constructed questionnaire. Relevant statistical tests, using SPSS, was performed for data analysis.

Results

At the final follow-up, the mean Kujala score was significantly improved from 72 points (range 53-94) to 95 points (range 87-100) (p<0.001). Similarly, the VAS score is significantly reduced from 3.5 points (range, 0-6) preoperatively to 1 point (range, 0-3) postoperatively (p<0.001). Postoperatively, 25 patients (76%) were very satisfied with the surgery, 7 patients (21%) were satisfied and 1 patient (3%) was neutral with the surgery. One patient reported frequencies of subluxation of the patella with a positive apprehension, others did not report any cases of dislocation. Superficial infection was evident in 2 patients with a complete resolution with oral antibiotics and regular dressing change.

Conclusion

MPFL reconstruction using superficial quadriceps tendon for the recurrent patella dislocation provides satisfactory functional outcomes with minimal complications, and is a cost-effective method for countries like Nepal as this technique requires only a single bioabsorbable screw in femoral side.

Keywords: recurrent patellar dislocation, medial patellofemoral ligament, quadriceps tendon,

References
[1]. Goyal D. Medial patellofemoral ligament reconstruction: the superficial quad technique. Am J Sports Med. 2013 May;41(5):1022–9
[2]. Fink C, Veselko M, Herbort M, Hoser C. Minimally Invasive Reconstruction of the Medial Patellofemoral Ligament Using Quadriceps Tendon. Arthrosc Tech. 2014 Jun;3(3):e325–9
[3]. Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 1993;9(2):159–63.