Functional outcome of Medial patellofemoral ligament injury (MPFL) reconstruction in recurrent patellar dislocation

Author(s): Madan Ballal, Vamsinath P and Nawaz Basha MS

Abstract: Introduction: Patella dislocation is defined as interposition of patella out of the trochlear groove. Patella dislocation is typically lateral and most often traumatic. Surgical treatment for patellar dislocation has evolved from the initial medial reefing to the present day anatomical reconstruction of MPFL which is thought to be the most appropriate treatment. MPFL reconstruction has been recommended in adults over the past decade after recurrent patellar instability. Many studies have shown good clinical outcome with this procedure compared to others. This study is undertaken in order to evaluate, clinical results of MPFL reconstruction. Materials and methods: This prospective study included 20 cases of recurrent dislocation of patella patients of either sex fitting the inclusion criteria at the Orthopedic Department of Sanjay Gandhi Institute of Trauma and Orthopedics, Bangalore from September 2016 To December 2017. Patients admitted with MRI proven mpfl tear after meeting the inclusion and exclusion criteria are selected. They will undergo detailed history, clinical and radiological evaluation. Mpfl repair was done by a single trained surgeon. Post-operative rehabilitation as per standard protocol. Postoperative evaluation done at 1 year. Lysholm and kujala scoring done at preoperative and postoperative follow-ups. Results: The mean age in our study is 24.4years. Majority are in the age group 15 to 45yrs. Mean kujala score increased from 50.8 to 93.7 which is statistically significant (p<0.005). Lysholm score has increased from 54.05 to 90.65 which is statistically significant (P value <0.005). Preoperatively 17 patients had poor and 3 patients had fair Lysholm score which changed to excellent in 13 patients, good in 5 patients and fair in 2 patients. Conclusion: MPFL reconstruction using an autologous hamstring graft with suture anchors gave a good preliminary outcomes; it greatly helps in preventing further episodes of patellar subluxations or dislocations and in improving quality of life. Further clinical studies are needed to confirm these early results.

DOI: https://doi.org/10.22271/ortho.2018.v4.i4d.38