DOS BULLETIN - Dansk Ortopædisk Selskab

2010-378_DOS nr. 3 2010 29/09/10 10:08 Side 113
Medial patellafemoral ligament reconstruction results
in good patient satisfaction. A retrospective study
Jens Christian Pørneki, Siamak Bahari
Background: Patellofemoral dislocations are common. In cases with
recurrence or residual instability, surgical intervention is usually considered
due to poor results with conservative and physiotherapeutic treatment.
Numerous treatment protocols have been used to treat
patellofemoral instability secondary to patella dislocation.
Purpose: The aim of the study was to analyze the clinical outcome 12-
36 month after MPFL reconstruction according to patient satisfaction
and re-dislocation.
Methods: 26 patients (23 female and 3 men) age 14-31 with recurrence
luxations of the patella were included. They all underwent MPFL- reconstruction
from 2007 -2009. The patients were questioned by validated
questionnaire (Kujala knee function score). Reconstruction was performed
suturing the gracilis tendon autograft to the medial part of the
patella with two anchors, and fixed at the anatomical MPFL insertion
site on the medial femoral condyle with an interference screw.
Findings: All included patients participated. No patella re-dislocation
was reported. Subluxation occurred in 2 patients (8 %). 5 patients (20%)
had chronic pain at follow-up. According to surgery description, these 5
patients had cartilage injury at the time of the reconstruction. The Kujala
knee function score improved overall from 44 points (range, 15 to 65
points) to 83 points (range, 60 to 99 points).
Conclusion: This study shows that MPFL reconstruction with gracilis
tendon graft sutured to the medial part of the patella with two anchors
provides good postoperative patellar stability and seems equal to other
surgical techniques in terms of patient satisfaction. Postoperative pain
seems to be related to the degree of patellofemoral cartilage injury found
at surgery.
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