Short‐term benefits of hybrid graft in medial patellofemoral ligament reconstruction for recurrent patellar dislocation: A prospective randomized controlled trial with minimum 2‐year follow‐up

Purpose This study aimed to compare short‐term functional and radiological outcomes between autograft and hybrid graft reconstruction in medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar dislocation and explore reasons for differences. Methods This prospective randomized controlled trial enroled 51 patients with recurrent patellar dislocation undergoing MPFL reconstruction between January 2020 and January 2023. Major exclusions included severe trochlear dysplasia (Dejour Type B–D), open physis, patella alta, severe lower limb malalignment (knee valgus angle >20°, femoral anteversion >25° or external tibial torsion >30°) and tibial tubercle–trochlear groove (TT–TG) distance ≥20 mm. Patients were randomly assigned to autograft or hybrid graft groups; the hybrid graft comprised a semitendinosus tendon and 6‐mm artificial ligament tape. The primary outcome was the 12‐month Kujala score, prespecified for early functional recovery. Secondary outcomes included Kujala and International Knee Documentation Committee (IKDC) scores at other time points and imaging parameters (patellar lateral tilt [PLT] angle and patellar‐trochlear groove [PTG] distance) preoperatively, immediately postoperatively and at final follow‐up. Results Forty‐six patients were included in the final analysis (autograft, n = 22; hybrid graft, n = 24). Mean age was 19.3 years; 82.6% (38/46) were female. Baseline characteristics and preoperative functional scores were comparable between groups (all p > 0.05). Significant improvements in subjective knee scores were observed in both groups at 3, 6, 12 months and final follow‐up ( p < 0.05). At 3 months, mean Kujala and IKDC scores were 68.6 ± 5.2 and 68.0 ± 6.1 in the autograft group versus 82.4 ± 4.3 and 82.9 ± 3.3 in the hybrid graft group (both p < 0.001). At 6 months, corresponding scores were 83.4 ± 3.6 and 83.3 ± 3.3 versus 88.4 ± 4.6 and 88.0 ± 4.9 (both p < 0.05). No significant between‐group differences were observed at 12 months or final follow‐up (all p > 0.05). No significant between‐group differences in PLT angle and PTG distance were observed immediately postoperatively or at final follow‐up (all p > 0.05), with significant improvements from preoperative values in both groups ( p < 0.05). Conclusion In carefully selected patients with recurrent patellar dislocation, MPFL reconstruction using a hybrid graft achieved satisfactory short‐term clinical and radiographic outcomes and was associated with improved early functional recovery at 3 and 6 months. The hybrid graft may be a feasible option for MPFL reconstruction. Level of Evidence Level II.