J Knee Surg 2020; 33(11): 1140-1146
DOI: 10.1055/s-0039-1692654
Original Article

Midterm Results after Implant-Free Patellar Fixation Technique for Medial Patellofemoral Ligament Reconstruction

Philipp Mayer
1   Center for Sports Orthopedics and Special joint surgery, Orthopedic Hospital Markgröningen, Markgröningen, Germany
,
Philipp Schuster
1   Center for Sports Orthopedics and Special joint surgery, Orthopedic Hospital Markgröningen, Markgröningen, Germany
2   Paracelsus Medical Private University, Clinic Nuremberg Departement of Orthopedics and Traumatology, Nuremberg, Germany
,
Michael Schlumberger
1   Center for Sports Orthopedics and Special joint surgery, Orthopedic Hospital Markgröningen, Markgröningen, Germany
,
Martin Eichinger
1   Center for Sports Orthopedics and Special joint surgery, Orthopedic Hospital Markgröningen, Markgröningen, Germany
,
Michael Pfaff
1   Center for Sports Orthopedics and Special joint surgery, Orthopedic Hospital Markgröningen, Markgröningen, Germany
,
Micha Immendörfer
1   Center for Sports Orthopedics and Special joint surgery, Orthopedic Hospital Markgröningen, Markgröningen, Germany
,
Jörg Richter
1   Center for Sports Orthopedics and Special joint surgery, Orthopedic Hospital Markgröningen, Markgröningen, Germany
› Author Affiliations
Funding None.

Abstract

Problems and complications concerning the patellar fixation in medial patellofemoral ligament reconstruction (MPFLR) have been reported. The purpose of this retrospective study was to systematically analyze the surgical technique for MPFLR with a V-shaped patellar bonetunnel for implant-free fixation of an autologous gracilis tendon, allowing early functional rehabilitation, regarding restoration of the patellofemoral stability, patient satisfaction, return to sports, and technique-specific complications. In 2010, 128 cases of consecutive isolated MPFLR were performed. All these cases were included. After a minimum follow-up of 3 years, 104 cases were retrospectively analyzed (follow-up: 81.3%) with regard to redislocation, subjective functional outcome (Tegner's score and sports level compared with preoperative level), patient satisfaction, revision surgery, and technique-specific complications. After a follow-up of 45.7 ± 3.2 months, 101 of 104 cases (97.1%) showed no redislocation. Mean Tegner's score was 5.1 ± 1.8 (range, 2–9). A total of 61.5% patients reported about a higher sports level compared with their preoperative level. The patient satisfaction was high with 94.2%. In two cases (1.9%), technique-specific problems occurred as the bone bridge of the V-shaped tunnel was insufficient due to a malpositioning of the aiming device. No further technique-specific problems occurred and no revision surgery was necessary during the observational period. The presented surgical technique is safe and it reliably restores the patellofemoral stability, with a low rate of redislocations, an excellent subjective functional outcome, and a high-patient-reported satisfaction. No major technique-specific complications occurred.



Publication History

Received: 04 November 2018

Accepted: 05 May 2019

Article published online:
03 July 2019

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.

 
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