Early Results of Patients With Recurrent Patellar Instability Treated With MPFL Reconstruction

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Abstract

Introduction: MPFL reconstruction is an evidence-based and successful technique in treating patients with recurrent patellar instability without alignment problems or who have not yet undergone skeletal maturity for distal realignment surgery. Aim: The aim of this study is to report early results of patients who underwent MPFL reconstruction Method: 21 patients with lateral patellar instability who were treated with MPFL reconstruction using hamstring autogrefts in our clinic between 2012 and 2013 were evaluated. Mean age was 18.8 (8-32). Average age of first patellar dislocation was 13 (5-18). Patients’ history of complaints, pre and postoperative knee ROMs, patellofemoral pain scales, and patellofemoral instabilities were evaluated. These evaluations were done using Kujala score, İKDC (International Knee Documentation Committee) score, KOS(Knee Outcome Survey Activities Of Daily Living Score) score, Tegner activity score and VAS score. Results: 86% of our patient reported getting better with the surgery. The mean follow up was 25,2 months.Median Kujala score rose from 71 preop to 96 postop(p<0.05) and median İKDC score rose from 72 to 95(p<0.05). VAS score decreased from 3.4 to 1.2. KOS score was on average 83. Tegner activity score of our patients which was 2.57 preoperatively increased to 4.71. Only one patient had a decreased range of flexion (10 degrees on terminal flexion) and only one patient had persisting recurrent patellar dislocation (%4). The failure to treat this patient was attributed to his concurrent patologies consisting of patella alta, trochlear dysplasia and patellofemoral malalignment. Conclusion: MPFL reconstruction with hamstring autograft for treating patellar instability seems to be an effective surgical option according to early results. For late term results further follow-up is needed.