Minimal invasive MPFL reconstruction using quadriceps tendon graft with lateral release: 2 years follow up

Background: Medial Patellofemoral Ligament (MPFL) reconstruction is a popular procedure to repair recurrent patellar dislocation. Many methods of reconstruction describe the use of hamstring tendons as the graft of choice. This study aimed to compare the functional outcome of MPFL reconstruction using quadriceps tendon graft with arthroscopic lateral release and to identify possible risks. Methods: This is a retrospective cohort study in patients with a history of recurrent dislocation trauma from 2014 to 2016 that already done MPFL reconstruction using quadriceps tendon grafts with arthroscopic lateral release. Patient reported outcomes were evaluated pre-operative and 2 years post-operatively using IKDC score, Lysholm knee score, Kujala score, KSS Score, thigh circumference size, and kneel down ability. Patellar fracture, redislocation, and other complications were also assessed 2 years post-operative. Results: Eight patients included in this study and showed significant improvement in clinical outcomes. The Lysholm score increased from 64.37 ± 8.23 to 90.87 ± 3.23 (p = 0.011), IKDC score increased from 62.93 ± 7.52 to 88.36 ± 3.64 (p < 0.001). Kujala score increased from 60.87 ± 7.94 to 88.37 ± 4.34 (p < 0.001), KSS knee score increased from 83.25 ± 11 to 93.87 ± 1.73 (p = 0.012). KSS function also increased from 57.50 ± 11.65 to 88.13 ± 3.72 (p = 0.011) with decreased in thigh circumference (1–3 cm). Five patients have full ROM, able to kneeling, while 3 patients were able to kneeling with adjustments. There were no postoperative infection, patellar fractures nor redislocations. Conclusion: MPFL reconstruction using quadriceps tendon grafts with arthroscopic lateral release can provide improved clinical results without complications of patellar fracture or stiffness of the knee, infection, and redislocation. Level of evidence: Level 3, Retrospective Cohort Study. Highlights: