MPFL reconstruction using a quadriceps tendon graft: Part 2: Operative technique and short term clinical results

•MPFL reconstruction using a strip of quadriceps tendon in the described technique was found feasible and was associated with good short term clinical and cosmetic results.•We think that this technique presents a valuable alternative to common hamstring techniques.•This technique can be used for primary MPFL reconstruction in children and adults as well as for MPFL revision surgery.

BackgroundWe describe the preliminary clinical results of a new operative technique for MPFL reconstruction using a strip of quadriceps tendon (QT).MethodsPatients: 17 patients (7 male, 10 female; mean age 21.5 years ± 3.9) have been operated on with this technique. All patients were evaluated clinically, radiologically and with subjective questionnaires (Tegner-, Lysholm-, Kujala Score) pre-operatively and post-operatively at 6 and 12 months (m).Surgical technique: A 10 to 12 mm wide, 3 mm thick and 8 to 10 cm long strip from the central aspect of quadriceps tendon is harvested subcutaneously. The tendon strip is then dissected distally on the patella, left attached, diverged 90° medially underneath the medial prepatellar tissue and fixed with 2 sutures. The graft is fixed in 20° of knee flexion with a bioabsorbable interference screw.ResultsLysholm score at 6 m was 81.9 ± 11.7 and at 12 m 88.1 ± 10.9, Kujala score at 12 m was 89.2 ± 7.1 and Tegner Score was 4.9 ± 2.0 (6 m) and 5.0 ± 1.9 (12 m). Two patients had a positive apprehension test at 12 months. There was no re-dislocation during the follow-up period.ConclusionMPFL reconstruction with a strip of QT harvested in a minimal invasive technique was found to be associated with good short term clinical results. We think that this technique presents a valuable alternative to common hamstring techniques for primary MPFL reconstruction in children and adults, as well as for MPFL revision surgery.Level of evidenceIV, prospective case series.