Evaluation of the Results of Reconstruction of Medial Patellofemoral Ligament in the Treatment of Recurrent Patellar Instability Using Hamstring Autograft by Dual Patella Docking Technique

Abstract

Abstract Background: Recurrent patellar instability can significantly affect a patient’s life quality. This study evaluated the results of medial patellofemoral ligament (MPFL) reconstruction in the recurrent patellar instability treatment using hamstring autograft by dual patellar docking technique. Materials and Methods: This prospective study was performed on 20 recurrent patellar instability patients. Magnetic resonance imaging and computed tomography scans were performed to confirm MPFL tear and assess the tibial tubercle-trochlear groove distance. Various clinical and radiographic evaluations were performed preoperatively. The surgical technique involved diagnostic arthroscopy, graft preparation, patellar preparation, graft passage, femoral tunnel preparation, and graft fixation. Results: Postoperatively, a substantial progression was observed in the International Knee Documentation Committee score, Kujala score, Cincinnati score, and Lysholm score compared to preoperative values ( P < 0.001). In addition, the postoperative measurements of patellar tilt angle and patellar congruence angle were significantly lower than their respective preoperative values ( P < 0.001). All 20 (100%) patients had negative findings in the postapprehension test, indicating improved stability. In the postcompression test, 3 (15%) patients showed positive results, whereas 17 (85%) patients had negative results. In terms of complications, 2 (10%) patients experienced patellofemoral pain, 1 (5%) patient had residual patellar translation without dislocation, 1 (5%) patient had limited flexion, and the majority of patients (16, 80%) had no complications. Conclusions: MPFL reconstruction with patellar docking yielded good results with Kujala and Lysholm, as well as adequate, satisfactory congruence angles for most patients. This procedure has exhibited a high success rate in addressing patellofemoral instability.