2020Nepal Orthopaedic Association JournalOpen access

Medial Patellofemoral Ligament Reconstruction Using Superficial Quadriceps Tendon Offers Satisfactory Results in Recurrent Patellar Dislocation

Binod Sherchan, Vaskar Humagain, Saroj Rai

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Abstract

Introduction: This study aims to assess the functional outcomes of patients undergoing medial patellofemoral ligament reconstruction using superficial quadriceps tendon and also assess the postoperative complication and patient’s satisfaction level. Methods: We retrospectively reviewed 33 patients (15 males, 18 females) with an average age of 19 years with recurrent patellar dislocation, operated from August 2015 to January 2018. Inclusion criteria of the study was patients with a recurrent patellar dislocation undergoing medial patellofemoral ligament reconstruction with a minimum follow-up of 1 year. Exclusion criteria of the study were: (1) associated ligamentous injuries of the knee joint, and (2) previous history of bony correction along with medial patellofemoral ligament reconstruction. The clinical evaluation was performed using Kujala knee score and visual analogue scale scores. Postoperative satisfaction level was performed using a self-constructed questionnaire.Results: At the final follow-up, the mean Kujala score was significantly improved from 72 points (range 53-94) to 95 points (range 87-100) (p<0.001). Similarly, the VAS score is significantly reduced from 3.5 points (range, 0-6) preoperatively to 1 point (range, 0-3) postoperatively (p<0.001). Postoperatively, 25 patients (76%) were very satisfied with the surgery, 7 patients (21%) were satisfied and 1 patient (3%) was neutral with the surgery. One patient reported frequencies of subluxation of the patella with a positive apprehension, others did not report any cases of dislocation. Superficial infection was evident in 2 patients with a complete resolution with oral antibiotics and regular dressing change. Conclusion: medial patellofemoral ligament reconstruction using superficial quadriceps tendon for the recurrent patella dislocation provides satisfactory functional outcomes with minimal complications and is a cost-effective method for the countries like Nepal. Keywords: Recurrent patellar dislocation, Medial patellofemoral ligament, Quadriceps tendon, Hamstring tendon

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Introduction: This study aims to assess the functional outcomes of patients undergoing medial patellofemoral ligament reconstruction using superficial quadriceps tendon and also assess the postoperative complication and patient’s satisfaction level. Methods: We retrospectively reviewed 33 patients (15 males, 18 females) with an average age of 19 years with recurrent patellar dislocation, operated from August 2015 to January 2018. Inclusion criteria of the study was patients with a recurrent patellar dislocation undergoing medial patellofemoral ligament reconstruction with a minimum follow-up of 1 year. Exclusion criteria of the study were: (1) associated ligamentous injuries of the knee joint, and (2) previous history of bony correction along with medial patellofemoral ligament reconstruction. The clinical evaluation was performed using Kujala knee score and visual analogue scale scores. Postoperative satisfaction level was performed using a self-constructed questionnaire.Results: At the final follow-up, the mean Kujala score was significantly improved from 72 points (range 53-94) to 95 points (range 87-100) (p<0.001). Similarly, the VAS score is significantly reduced from 3.5 points (range, 0-6) preoperatively to 1 point (range, 0-3) postoperatively (p<0.001). Postoperatively, 25 patients (76%) were very satisfied with the surgery, 7 patients (21%) were satisfied and 1 patient (3%) was neutral with the surgery. One patient reported frequencies of subluxation of the patella with a positive apprehension, others did not report any cases of dislocation. Superficial infection was evident in 2 patients with a complete resolution with oral antibiotics and regular dressing change. Conclusion: medial patellofemoral ligament reconstruction using superficial quadriceps tendon for the recurrent patella dislocation provides satisfactory functional outcomes with minimal complications and is a cost-effective method for the countries like Nepal. Keywords: Recurrent patellar dislocation, Medial patellofemoral ligament, Quadriceps tendon, Hamstring tendon

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Available abstract

Introduction: This study aims to assess the functional outcomes of patients undergoing medial patellofemoral ligament reconstruction using superficial quadriceps tendon and also assess the postoperative complication and patient’s satisfaction level. Methods: We retrospectively reviewed 33 patients (15 males, 18 females) with an average age of 19 years with recurrent patellar dislocation, operated from August 2015 to January 2018. Inclusion criteria of the study was patients with a recurrent patellar dislocation undergoing medial patellofemoral ligament reconstruction with a minimum follow-up of 1 year. Exclusion criteria of the study were: (1) associated ligamentous injuries of the knee joint, and (2) previous history of bony correction along with medial patellofemoral ligament reconstruction. The clinical evaluation was performed using Kujala knee score and visual analogue scale scores. Postoperative satisfaction level was performed using a self-constructed questionnaire.Results: At the final follow-up, the mean Kujala score was significantly improved from 72 points (range 53-94) to 95 points (range 87-100) (p<0.001). Similarly, the VAS score is significantly reduced from 3.5 points (range, 0-6) preoperatively to 1 point (range, 0-3) postoperatively (p<0.001). Postoperatively, 25 patients (76%) were very satisfied with the surgery, 7 patients (21%) were satisfied and 1 patient (3%) was neutral with the surgery. One patient reported frequencies of subluxation of the patella with a positive apprehension, others did not report any cases of dislocation. Superficial infection was evident in 2 patients with a complete resolution with oral antibiotics and regular dressing change. Conclusion: medial patellofemoral ligament reconstruction using superficial quadriceps tendon for the recurrent patella dislocation provides satisfactory functional outcomes with minimal complications and is a cost-effective method for the countries like Nepal. Keywords: Recurrent patellar dislocation, Medial patellofemoral ligament, Quadriceps tendon, Hamstring tendon

Key concepts: Medial patellofemoral ligament, Medicine, Subluxation, Surgery, Patellar ligament, Patella, Range of motion, Ligament

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