Medial Patellofemoral Ligament Reconstruction With Two Semi-patellar Tunnel Fixation:Surgical Technique And Mid-term Follow-up

Objective: The present study aimed to describe a new safe and economical technique for medial patellofemoral ligament(MPFL)reconstruction with satisfactory clinical outcomes,and present the results of a four-year follow-up.Methods: Thirty-two patients with recurrent patella dislocation,who underwent MPFL reconstruction with two semi-patellar tunnels and hardware-free patellar fixation between 2011 and 2013,were included in the study.Patella stability was tested by an apprehension test preoperatively and at follow-up.Knee function was evaluated using the Kujala score and Lysholm score.Patellar congruence angle and patellar tilt angle were measured using an axial computed tomography scan.Furthermore,objective feelings of patients and complications were recorded.Results: Thirty knees(30 patients)were followed for a minimum of 48 months.The apprehension test was positive in all patients preoperatively,but negative at follow-up.Kujala and Lysholm scores increased from 58.9 ± 9.6to 92.0 ± 4.8(P < 0.001)and 53.3 ± 5.6 to 91.6 ± 3.5(P < 0.001),respectively,at the last follow-up.The patellar congruence angle and patellar tilt angle also improved significantly.No patient experienced patellar re-dislocation,subluxation,or patella fracture.Most patients(93%)were satisfied with the surgery.Conclusions: MPFL reconstruction with two semi-patellar tunnels and hardware-free patellar fixation was described and the study observations indicated it was a safe and economical surgical procedure for recurrent patella dislocation with satisfactory results.It could be an alternative surgery method for patients with patella recurrent dislocation.