Title : MPFL reconstruction: A different approach
Abstract:
Background: Numerous surgical techniques of Medial Patellofemoral Ligament (MPFL) reconstruction have been described in the literature with no one technique found to be superior to the other. However, most techniques require drilling bone tunnels in either the patella or femur or both, which can lead to complications such as iatrogenic fracture.
Aim: To describe a different surgical technique that avoids creating bone tunnels and thereby prevents iatrogenic fractures.
Methods: A cohort study was conducted on patients with isolated MPFL injury who underwent MPFL reconstruction between September 2018 and August 2020. The surgical technique employed did not involve creating bone tunnels. Patients were followed up for a minimum of 2 years, and postoperative assessment was done by clinical examination and functional assessment knee scores using Tegner-Lysolhm knee score and Kujala score.
Results: None of the study participants experienced instability, re-dislocation, or patellar fractures during the postoperative period. The mean lateral patellar translation was 1.8 quadrants, and patellar tracking was normal with a negative patellar apprehension test in all participants. The Tegner-Lysolhm Knee Score was good to excellent for 58.6% of participants, fair for 34.5%, and poor for 6.9%. The Kujala Anterior Knee Pain score was more than 80 in 65.5% of participants, and none had a score of less than 60.
Conclusion: The surgical technique described in this study avoided the complication of iatrogenic fractures associated with traditional MPFL reconstruction techniques. Furthermore, the functional outcomes were comparable to those reported in previous studies.
