Evaluation of Medial Patellofemoral Ligament Reconstruction in Skeletally Inmature Patients. Comparative study of two different techniques

Abstract

Patellofemoral dislocation accounts for 3% of traumatic knee injuries, with two-thirds occurring in patients under twenty years of age. Recurrence after the second episode is greater than 50%, which can cause great functional limitation in young patients, reducing their quality of life. Medial patellofemoral ligament (MPFL) is the main medial stabilizer of the patella at 30° flexion, currently its anatomic reconstruction preserving the physis appears to be the best option in patients with immature skeleton. Functional results of two groups of patients treated by two different techniques of MPFL reconstruction were evaluated. One anatomic technique, with autologous Semitendinosus (ST) and the other non-anatomic, with autologous quadricipital hemi tendon (QT). Both groups were evaluated through the Kujala score before surgery and during follow-up. Means and score items were compared using Wilcoxon signed-rank test.

Twenty-two knees were evaluated, eleven in each group. Patient’s age ranged between eight and fifteen years old. The mean follow-up was 19.4 months. An improvement in the average Kujala scores for the ST group from 51 to 88 and in the QT group from 52 to 97 was shown. Kujala score was statistically significantly higher in the postoperative evaluation with both technics (p-value 0.003 for both groups), no differences were found between both technics. Only one case of patella redislocation was registered during the study period (QT group). We can affirm that MPFL reconstruction is a valid therapeutic option for patellofemoral dislocation and the proposed techniques are reliable choices.