Clinical and patient-reported outcomes of Medial Patello Femoral Ligament (MPFL) reconstruction using Quadriceps Tendon (QT): A mixed-methods study

Title : Clinical and patient-reported outcomes of Medial Patello Femoral Ligament (MPFL) reconstruction using Quadriceps Tendon (QT): A mixed-methods study

Abstract:

Background: Medial Patello Femoral Ligament (MPFL) reconstruction is a well-established procedure for managing patellar instability. Among available graft options, the Quadriceps Tendon (QT) has gained increasing interest due to its strength and lower donor-site morbidity. However, local data particularly those incorporating both clinical outcomes and patient experiences remain limited.

Methods: A mixed-methods study was conducted involving patients who underwent MPFL reconstruction using QT graft at a tertiary hospital. Quantitative outcomes were assessed using Kujala and International Knee Documentation Committee (IKDC) scores at 3, 6, and 12 months postoperatively. Repeated-measures ANOVA was used to evaluate changes over time. Postoperative complications, including graft failure and recurrent dislocation, were recorded. Qualitative data were obtained through semi-structured interviews with patients and surgeons and analyzed using thematic analysis.

Results: Fourteen patients (mean age 22.2 ± 5.2 years; 64.3% female) were included. Significant improvement in functional outcomes was observed, with mean Kujala scores increasing from 69.43 ± 2.74 at 3 months to 96.07 ± 3.50 at 12 months, and IKDC scores improving from 30.30 ± 2.61 to 74.55 ± 2.29 (p < 0.001). No intraoperative or postoperative complications, including graft failure or recurrent instability, were observed within the 12-month follow-up. Qualitative analysis revealed consistent themes of improved knee stability, high patient satisfaction, and favorable surgeon perception of graft reliability and ease of harvest, with femoral tunnel placement identified as the most technically demanding step.

Conclusion: MPFL reconstruction using the quadriceps tendon demonstrates significant functional improvement, low complication rates, and high patient satisfaction in this cohort. The integration of clinical and qualitative findings supports QT as a safe, effective, and reproducible graft option. Further multicenter studies with larger populations are recommended to validate these findings.

Biography:

Dr. John Jetherwin S. Saldua, is a Filipino physician currently serving as a 5th year Orthopaedic Surgery resident at Jose B. Lingad Memorial General Hospital (JBLMGH), San Fernando, Pampanga, Philippines, and the Chief Resident of the department. He earned his Doctor of Medicine degree from Angeles University Foundation in 2019, following his Bachelor of Science in Nursing at Holy Angel University. He passed Physician Licensure Examination in November 2020 and gained experience as an Emergency Room Physician in multiple institutions prior to pursuing specialization in orthopaedic surgery. His clinical interests include adult orthopaedics, particularly arthroplasty, sports injuries, orthopaedic infections, musculoskeletal tumors, and complex fracture management. As Chief Resident,he is actively involved in clinical leadership, resident training, and the coordination of surgical services within his department.