Double bundle medial patello-femoral ligament reconstruction for recurrent patellar dislocation – A modified technique and documentation of importance of arthroscopy

AimEvaluation of outcome of double bundle MPFL reconstruction for recurrent patellar dislocation using semitendinosus tendon autograft passed through vertical tunnel in patella and to document the scope of arthroscopic assistance during the procedure.MethodsThe prospective case series study included 22 patients (17 females and 5 males) with recurrent lateral patellar dislocation. The average age was 29 years (15–55 years) and all underwent arthroscopy-assisted MPFL reconstruction using semitendinosus tendon autograft passed through vertical tunnel in patella.ResultsAt an average follow-up of 30 months (17–43 months), none had apprehension or re-dislocation of patella postoperatively. Intraoperative arthroscopy was useful in the confirmation of patella tracking; removal of loose body (9 cases), performing chondroplasty (11 cases), simultaneous management of associated intra-articular pathology (4 cases) and careful tunnel placement for tendon graft. Radiologically, the congruence angle improved from pre-operative average of 13.41° (−9° to +53°) to 2.59° (−10° to +14°) and the lateral patellar tilt angle improved from 11.95° (2° to 21°) to 4.18° (0° to 9°) post-operatively. Functionally, the Kujala score improved from pre-operative average of 49.59 (42–76) to 92.18 (86–96), the Lysholm score from 62.13 (56–70) to 94.31 (90–100) and the Tegner activity scale from 2.31 (2–3) to 3.31 (3–4) post-operatively.ConclusionDouble bundle MPFL reconstruction for recurrent patellar dislocation using looped semitendinosus tendon autograft passed through vertical tunnel in patella produces promising radiological and functional results. The study highlights the value of arthroscopic assistance during the procedure to improve the outcome.