Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleReconstruction of the Medial Patellofemoral Ligament With Gracilis Tendon Autograft in Transverse Patellar Drill Holes
Section snippets
Patients
This study included 44 patients who were consecutively operated on. Patients underwent surgery from May 2003 to December 2005. Mean follow-up was 22 months (range, 12 to 32 months), and 45% of the patients had 2 years of follow-up or more. The patients’ median age was 22 years (range, 12 to 47 years). There were 15 male and 29 female patients. All patients had chronic patellar instability with a minimum of 2 total patellar dislocations. The median period of preoperative patellar instability was
Results
Subjective patient assessment revealed that 80% of patients (35/44) felt that their knee function had improved in terms of activities of daily living and 37 of 44 patients indicated that their ability to perform recreational sports activities had improved. Of the patients, 64% (28/44) were completely pain-free when performing activities of daily living and 59% (26/44) were pain-free when performing sport activities. Four patients had persistent chronic pain. All of these patients had cartilage
Discussion
The optimal surgical treatment for chronic patellar instability is controversial. Numerous techniques have been used with varying success. Proximal realignment procedures, which cover medial capsule plication and lateral capsule release, have been investigated in a few studies. Scuderi et al.21 reported a low redislocation rate of 3% with isolated proximal realignment. A similar finding was reported by Aglietti et al.22 and Zeichen et al.23 Medial transfer of the tibial tuberosity, called
Conclusions
Early results with MPFL reconstruction with gracilis tendon in patellar drill holes show a low redislocation rate of 2% and medial hardware problems in approximately 7% of patients. The procedure is not able to eliminate apprehension and pain at the medial aspect of the patella. More persistent postoperative pain with activity is a problem that is related to patellofemoral chondral lesions.
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Complication Rates After Medial Patellofemoral Ligament Reconstruction Range From 0% to 32% With 0% to 11% Recurrent Instability: A Systematic Review
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The authors report no conflict of interest.