Abstract
Patella instability is a common problem with many surgical options. We prospectively evaluated the results of medial patella femoral ligament (MPFL) reconstruction with an autogenous gracilis or semitendinous graft. With a minimum follow up of one year patients were reviewed using the Kujala scoring system.
Twenty MPFL reconstructions were performed on seventeen patients over a two year period, from January 2004 to December 2005. There were 13 females and 4 males. Three patients had bilateral involvement. Thirteen patients had a lateral release with their MPFL reconstruction and three had a distal realignment procedure as well to correct their patella instability.
The mean follow up was 17 months (range 12 to 26 months). The average age was 25 years old at operation (range 13 to 47) and the average age of their first dislocation was 16 (range 0-35). Nine patients had previous surgical treatment for patella instability. The average hypermobility score in the patients was 5/9 and six patients scored 9/9.
At follow up 18 out of 20 patients (90%) had stable tracking with no further subluxations/dislocations. Of the two with unstable tracking, one had a stable patella before falling several times onto her knee. An MRI confirmed the ligament was intact but a type 2 trochlear dysplasia was present and a Bereiter trochleoplasty was subsequently performed. The other patient described no frank dislocation but instead subluxations.
Eighteen of the twenty reconstructions (90%) achieved a stable patella. Overall Kujala scores increased by a third.
