Soft-tissue Fixation Of Medial Patellofemoral Ligament Reconstruction For Treatment Of Recurrent Dislocation Of Patella In Adolescents

Background: Recurrent dislocation of patella is a common disease of knee,which mainly occurred in adolescents.Reconstruction of the medial patellofemoral ligament(MPFL)fixated by bone tunnels and implants are the widely accepted methods for the treatment of patellar dislocation.However,these bone tunnels and implants procedures are not applicable for adolescent patients with open growth plates.An alternative soft-tissue fixation method may be required.Purpose: To investigate the technique and efficacy of soft-tissue fixation in reconstruction of MPFL in treatment of recurrent dislocation of patella in adolescents.Methods: A total of 12 adolescents who had recurrent dislocation of patella underwent MPFL reconstruction between March 2014 and October 2016 were included.The autologous hamstring tendon was harvested and fixed using the all soft-tissue fixation method in MPFL reconstruction.A rapid rehabilitation program was carried out postoperatively.Clinical outcomes were evaluated using the Lysholm,IKDC,Kujala knee scores preoperatively and postoperatively during the follow-up.In addition,the degree of satisfaction to the surgery and the restoration of sports activities were also investigated.Results: All 12 patients were followed up for 6 to 18 months,with an average of 12 months.There was no recurrence of dislocation.During the final follow-up,all patients restored full range of activity and normal medial patellar stability.The Lysholm,IKDC,Kujala knee scores were significantly improved postoperatively compared with those preoperatively(P<0.01).10 cases were very satisfied with the operation and the other 2 cases were satisfied with the surgery.75%(9/12)of the patients could fully regain the sport abilities in 6 months after surgery(non-professional athletes).Conclusion: Reconstruction of MPFL with soft-tissue fixation method has achieved remarkable clinical results without severe complications associated with bony procedures.For the adolescent patients with open growth plates,this is a safe,effective and reliable surgical technique in fixation of MPFL grafts.