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Isolated medial patellofemoral ligament reconstruction for posttraumatic recurrent lateral patellar instability. How can it be successful?

Azim Foda, Adel Abdel MD; Aabdel Salam, Mohamad A. MD

doi: 10.1097/BCO.0000000000000540
ORIGINAL RESEARCH
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Background: Injury to the medial patellofemoral ligament (MPFL) occurs in nearly all cases of traumatic patellar dislocation. Reconstruction of the MFPL is the main treatment of such conditions. Other anatomical abnormalities that predispose to lateral patellar instability should be excluded for successful outcome after isolated MPFL reconstruction.

Methods: In the period from June 2012 to January 2015, 18 patients with had recurrent posttraumatic unilateral lateral patellar instability caused by an isolated MPFL tear that was reconstructed with a semitendinosus autograft to reconstruct MPFL. The mean follow-up period was 24 mo. Patients with isolated MPFL tears were carefully chosen through a series of clinical and radiographic workups. The technique was done through a less invasive approach, with the graft fixed to the femur by a bioabsorbable interference screw and to the patella; the graft was passed through two transverse tunnels making a laterally based loop.

Results: No dislocations or apprehension was recorded. Furthermore, there were no major complications, only persistent patellofemoral pain in patients with preoperative osteochondral patellar injuries. Kujala functional score improved from 35.6 preoperatively to 90.4.

Conclusions: Careful patient selection and proper surgical technique are the two main items for patellar stabilization with isolated MPFL reconstruction.

Department of Orthopaedic Surgery, Zagazig University Hospital, Zagazig, Egypt

Financial Disclosure: The authors report no conflicts of interest.

Correspondence to Adel Abdel Azim Foda, MD, Orthopaedic Surgery, Zagazig University Hospitals, Zagazig University Hospital, New Surgery Building, 4th Floor Department, Faculty of Medicine Street, Sharkia Governorate, Zagazig City, Egypt Tel: +00201206007522; fax: +0020552330907; e-mail: Afoda77@gmail.com.

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