Purpose: To evaluate the patients who underwent acute surgical repair of medial patellofemoral ligament following first lateral dislocation of patella

Methods: Twenty four patients with mean age 19 yrs (12–41) who underwent acute repair of MPFL were reviewed. The mean follow-up was 14 months (2–35 months). All patients had MRI scan preoperatively and most of them were operated within two weeks of injury. Patients were evaluated clinically and Kujala and modified Lysholm were recorded. None of these patients had further dislocations and all had negative patellar apprehension tests. The mean Kujala and modified Lysholm scores were above 85.

Conclusion: Our results strongly support that in selected patients acute repair of MPFL prevents further dislocations and early return to sporting activities. The long term results are to be evaluated.

Introduction We performed an audit of tunnel position in primary anterior cruciate ligament reconstructions performed by two surgeons at a single centre. The audit cycle was opened with a retrospective review of a cohort of patients in order to establish existing surgical practice. Following this review our practice changed with the use of intra-operative image intensifier to confirm tunnel positions. The audit loop was closed with a prospective study of a second cohort of patients undergoing surgery using the new technique.

Results Twenty five patients were reviewed in each group. The case-mix for the two groups were similar with regard to age, sex, side, graft selection and surgical technique. The first cohort of patients had optimal tibial tunnel placement in 56% (sagittal) and 88% (coronal) of cases. The femoral tunnel was correctly positioned in the sagittal plane in 52% of patients. The second cohort, in which an intra-operative image-intensifier was used, had optimal tunnel position for the femur in 100% of cases and for the tibia (sagittal) in 48% of patients.

Conclusion In this study we have shown that the use of an image intensifier, intra-operatively, greatly improved femoral tunnel position but had no significant effect on tibial tunnel placement. We have also demonstrated that audit is effective in improving clinical practice.