MPFL Repair for Acute Patella Dislocation

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

Objectives: To report on the findings of a single surgeon series of MPFL(medial patello-femoral ligament) repair in the treatment of first time patella dislocation. Methods: 47 patients with 49 MPFL repairs for first time patella dislocation have been reviewed. All patients had pre-operative x-ray and MRI to define pathology, site of MPFL injury, presence of loose body/bodies, chondral injury etc. All patients underwent acute surgical repair at the site of injury to MPFL, as well as treatment of any secondary pathology. All patients were managed with a similar post-operative protocol of early weight bearing and range of motion utilizing a J-brace. Patients were contacted by phone or returned in person for completion of Kujula scores at time of reporting. Results: 40 patients with 42 knees were available for final follow-up. Average follow up period is 3-9 yrs. Average Kujula score 89/100. 3 of 42 recurrent dislocation for rate of 6.1%. 1 deep infection. MPFL rupture site 28/49 at patella (57%), 15/49 at femur (30%), 3/49 both patella and femur (6.1%),1/49 mid-substance (2%), 2/49 not seen on MRI or at surgery ( 4%) Osteochondral loose body 28/49 (57%) 9/49 required additional oft tissue surgery Conclusion: This series describes the location of MPFL injury in first time patella dislocation. In this surgical series there is a high incidence of secondary injury. At 3.9yr follow up this series demonstrates a recurrent dislocation rate of 6.1%.