To assess the midterm functional results after Medial Patellofemoral Ligament (MPFL) reconstruction with single semitendinosis autograft in patients with patellofemoral instability. Forty six knees (45 patients) with patellofemoral instability were treated with surgical stabilisation of the patella with a single semitendinosis autograft and followed up for a minimum of 24 months. The average follow-up was 33.5 months (range 24-54 months). Clinical evidence of patellar instability and radiological (MRI) evidence of MPFL rupture or deficiency was documented prior to surgery. The average post injury interval was 22.3 months. Ipsilateral joint co-morbidities included previous lateral release or distal realignment (n=10), patellofemoral joint (PFJ) dysplasia (n=14) and concurrent ACL, PCL and/or MCL rupture (n=6). Knee function was assessed preoperatively and postoperatively with the use of Kujala, Tegner, Lysholm and International Knee Documentation Committee (IKDC) scores. There were 34 male and 11 female patients with a mean age of 32.5 years (range 17 - 60 years). All measured knee function scores improved postoperatively. Kujala score improved from 58 to 77 (95%CI +/− 9.71). Tegner score improved from 3 to 5 (95%CI+/− 0.65). IKDC score improved from 51 to 75 (95%CI +/− 5.27) and Lysholm score improved from 59 to 79 (95%CI +/− 6.5).Purpose
Methods - Results
The aim of this study was to assess the knee function after MPFL reconstruction with single hamstring autograft. In this case series 68 patients (69 knees) were treated in total. Clinical and radiological evidence of patellar instability and MPFL rupture or deficiency was documented prior to surgery. The MPFL was reconstructed with semitendinosus autograft. The free end of the graft was rerouted through the most distal part of the medial intermuscular septum proximally to the adductor tubercle, to the superomedial border of the patella, where it was fixed, whereas its distal insertion to the tibia was preserved. Knee function was assessed preoperatively and postoperatively with the use of Kujala, Tegner, Lysholm and International Knee Documentation Committee (IKDC) scores. There were 46 male and 22 female patients with an average age of 25.8 years (median age 23) ranging from 11 to 54 years. The mean follow-up was 19.6 months (range 6-54 months). Ten of the patients had findings of femoral trochlear dysplasia. All knee functional scores significantly improved postoperatively. Kujala score improved from 56 to 84, Tegner score improved from 2 to 6, IKDC score improved from 48 to 75 and Lysholm score improved from 53 to 80. One of the patients required revision of the MPFL reconstruction following traumatic redislocation of the patella.AIMS
METHODS-RESULTS
Conclusions: At a midterm follow-up, reconstruction of the MPFL with rerouting of the semitendinosus tendon is an effective method with improved function in all patients. Maximum improvement was achieved within the first six postoperative months. Heterogeneity of our population may have affected some of our results.
The aim of the study was to assess the knee function after MPFL reconstruction with single hamstring autograft. In this case series 86 patients (87 knees) were treated in total, from July 2002 till December 2008. Clinical and radiological evidence of patellar instability and MPFL rupture or deficiency were documented prior to surgery. The MPFL was reconstructed with semitendinosus autograft. The tibial insertion of the graft was retained whereas its free end was rerouted through the most distal part of the medial intermuscular septum, to the supero-medial border of the patella, where it was fixed. Knee function was assessed preoperatively and postoperatively with the use of Kujala, Tegner, Lysholm and International Knee Documentation Committee (IKDC) scores. There were 60 male and 26 female patients with an average age of 29.73 years (median age 28) and range 16–54 years. The mean follow-up was 22.4 months (range 6–78 months). All knee functional scores significantly improved postoperatively. Kujala score improved from 61.3 to 84.8, Tegner score improved from 3 to 5.3, IKDC score improved from 52.4 to 73.8 and Lysholm score improved from 58 to 76.5. The comparison was made between the preoperative and the postoperative values at two years after surgery or at the last follow up, if it was shorter than two years. All scores showed significant improvement after the third postoperative month. One of the patients required revision of the MPFL reconstruction following traumatic redislocation of the patella. Rerouting of the semitendinosus tendon for the reconstruction of the MPFL is an effective method for the treatment of patellofemoral instability. Significant functional improvement is achieved between the third and sixth postoperative months
