01.10.2014 | Knee | Ausgabe 10/2014
Medial patellofemoral ligament reconstruction with bioactive synthetic ligament is an option. A 3-year follow-up study
Knee Surgery, Sports Traumatology, Arthroscopy
- Massimo Berruto, Paolo Ferrua, Francesco Uboldi, Eva Usellini, Luca Gala, Alberto Tassi, Bruno Marelli
The purpose of this study was to evaluate mid-term follow-up results of medial patellofemoral ligament (MPFL) reconstruction using a bioactive synthetic ligament in the treatment of objective patellofemoral (PF) instability.
Sixteen patients (18 knees) presenting with objective PF instability underwent a MPFL reconstruction, isolated or associated with other surgical procedures for PF stabilization. All patients were clinically evaluated at a minimum follow-up of 3 years. Kujala, subjective IKDC and KOOS scores were used to assess clinical outcome. Pre-operative and post-operative pain was quantified with VAS scale and the overall satisfaction graded according to Insall and Crosby. Although none of the patients in this series were involved in high-level sports activity because of patellofemoral instability, activity level pre-operatively and at follow-up were evaluated according to Tegner scale.
No recurrence of dislocation was observed in this series. The overall satisfaction rate was 88.8 %. Kujala score improved significantly from 57 ± 8.4 to 84.3 ± 10.2 points (p < .01). Both subjective IKDC (42.4 ± 7.13 to 70.1 ± 3.9) and KOOS (62.7 ± 4.34 to 82.8 ± 8.8) significantly improved from pre-operative evaluation (p < .01). VAS decreased from a mean pre-operative value of 2.5 ± 1.6 to 1.4 ± 1.5 at 3 years follow-up. Only one patient required revision debridement surgery for persistent medial epicondylar pain.
Isolated or associated MPFL reconstruction with bioactive synthetic ligament is a valid option in surgical treatment of objective PF instability, with results at mid-term follow-up comparable to autologous graft, thus minimizing donor-site morbidity and associated complications.