Description
Objectives: Medial Patellofemoral Ligament (MPFL) reconstruction serves as a therapeutic intervention for patellar instability. This study aims to delineate the regional experience with isolated MPFL reconstruction utilizing autologous hamstring grafts, emphasizing the demographic characteristics and clinical outcomes of the patient cohort.
Methods: We conducted a retrospective analysis of patients who underwent MPFL reconstruction between January 2010 and December 2014 at a tertiary institution in Singapore. Data extracted included pre-operative clinical manifestations, MRI results, post-operative follow-up duration, range of motion (ROM), Kujala and Lysholm scores, and any complications. Patient interviews were conducted a minimum of two years post-surgery.
Results: A total of 50 knees were operated on across 47 patients. The average age of the patients was 29.4 years (range: 16-60). Of these, 33 (70%) were female. A mere 16 patients could identify an inciting event leading to patellar instability. Notably, 24 (48%) presented with anatomical predispositions for patellar instability: 19 exhibited trochlear dysplasia, with 9 of these also showing an elevated tibial tuberosity-trochlear groove (TT-TG) distance. The remaining 5 had an isolated increased TT-TG distance.
The average Kujala score stood at 91.5 (range: 50-100, SD: 11.1), and the Lysholm score averaged at 92.3 (range: 64-100; SD: 9). No significant disparities were observed in post-operative ROM (p=0.489), Lysholm (p=0.709), and Kujala (p=0.770) scores, or in complication frequencies (p=0.490) between patients with and without anatomical abnormalities. Post-operative complications were reported by 10 patients (20%), with joint stiffness being the predominant issue.
Conclusions: The studied patient cohort predominantly exhibited chronic patellar instability, often subsequent to low-intensity trauma. Nearly half presented with anatomical factors predisposing them to patellofemoral instability. Isolated MPFL reconstruction proved largely efficacious. Notably, joint stiffness, rather than recurrent instability, emerged as the primary post-operative complication.
