2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress ePoster

 

Adductor Sling Versus Anatomical Technique In Medial Patellofemoral Ligament Reconstruction: A Retrospective Multicenter Study

Rodrigo Guiloff, MD, Prof, Santiago, Vitacura CHILE
Jose Tomas Arteaga, MD, Knee fellow, Viña Del Mar, State * CHILE
Jorge Simon Isla, MD, Santiago CHILE
José Luis Prado, Md, Santiago CHILE
Francisco Figueroa, MD, Santiago, RM CHILE
Alex Vaisman, MD, Prof., Santiago, RM CHILE
Rafael Calvo, MD, Santiago CHILE
David H. Figueroa, MD, Santiago, RM CHILE

Facultad de Medicina Clinica Alemana de Santiago Universidad del Desarrollo, Santiago, Región Metropolitana, CHILE

FDA Status Not Applicable

Summary

The adductor sling (AS) technique for MPFL reconstruction in adults offers lower costs without compromising outcomes compared to the anatomical technique (AT). This retrospective study found no significant differences in instability, failure rates, or Kujala scores between AS and AT, supporting AS as a viable alternative.

ePosters will be available shortly before Congress

Abstract

Introduction

The adductor sling (AS) technique described by Monllau et al. for medial patellofemoral ligament reconstruction (MPFLR) has lower costs without being clinically or functionally inferior to the anatomical technique (AT). However, the evidence to support its use in adults is limited.

Objective

To compare the clinical and functional outcomes of patients with recurrent patellofemoral instability (RPI) undergoing MPFLR using the AS versus the AT.

Method

A retrospective multicenter comparative study was conducted on patients undergoing MPFLR between 2019-2024 with prior authorization from the institutional ethics committee. Patients with immature skeletons, trochleoplasty, associated varus or derotational tibial osteotomy and follow-up less than 6 months were excluded. Patients were divided into 2 groups based on the technique used:
- Group 1 (AS): Dynamic fixation with sling on the adductor tendon.
- Group 2 (AT): Fixation with a screw in the femoral tunnel according to Schöttle's reference.

Subjective sensation of instability, failure rate (objectified instability or new surgery for redislocation), and Kujala score were compared. Statistical analysis included Mann Whitney U and Fisher tests (p<0.05).

Results

Eighty-five patients (20 AS/65 AT) met the selection criteria, with comparable groups in age (p=0.051) and sex (p=0.612). The mean follow-up time was 18 (6-25) and 37 (14-87) months for the AS and AT groups, respectively (p=0.001). Subjective sensation of instability was 20% and 27.7% (p=0.572), failure rate was 0% and 1.5% (p=0.999), and median Kujala score was 85 (53-100) and 91 (43-100) (p=0.196) for the AS and AT groups, respectively.

Conclusions

In this retrospective multicenter study, no significant differences were observed between patients undergoing MPFLR with AS and AT in terms of subjective sensation of instability, failure rate, and functional evaluation.