Anatomical Medial Patellofemoral Ligament Reconstruction in Management of Cases of Patellar Instability

Objectives: The purpose of this study was to evaluate the technique of anatomic Medial Patellofemoral Ligament (MP- FL) reconstruction for lateral patellar instability, and to assess clinical, radiographic results and complications associated with this procedure.Patients and Methods: From February 2013 to February 2016, 30 knees with patellar instability met the inclusion criteria and underwent MPFL reconstruction; 15 cases by suture anchors technique (50%), and 15 cases by patellar bone tunnels technique (50%). The mean duration of follow-up in our series was 8.93±5.32 months (6-29). There were 12 Males (40%) and 18 Females (60%) with a mean age of 25.97±6.79 years (15-42).Results: There was statistically significant improvement in postoperative Modified IKDC score from 40.93 to 65.72 (p 0.001), Kujala score from 49.63 to 72.50 (p 0.001), cincinatti score from 46.33 to 73.63 (p 0.001), Tegner-Lysholm score from 51.37 to 77.30 (p 0.001). At latest follow-up, the apprehension test was negative in all patients while compression test was positive in 6 patients (20%). No patient experienced patellar redislocation or subluxation between surgery and the latest follow-up. There was no significant difference in clinical or radiographic outcome between both techniques; suture anchor fixation technique, and patellar bone tunnels technique.Conclusion: Anatomic MPFL reconstruction is a reliable treatment option with little associated morbidity for the treatment for patellar instability, especially in patients without bony abnormalities. The procedure described here offers the opportunity of an anatomical MPFL reconstruction.