Double-bundle anatomical medial patellofemoral ligament reconstruction with lateral retinaculum plasty can lead to good outcomes in patients with patellar dislocation

Knee Surg Sports Traumatol Arthrosc. 2018 Sep;26(9):2743-2749. doi: 10.1007/s00167-017-4720-6. Epub 2017 Sep 20.

Abstract

Purpose: To evaluate the clinical outcomes of double-bundle anatomical medial patellofemoral ligament (MPFL) reconstruction combined with lateral retinaculum plasty versus isolated MPFL reconstruction for patellar dislocation.

Methods: From 2011 to 2013, 64 patients underwent either double-bundle anatomical MPFL reconstruction combined with lateral retinaculum plasty (Group A, 32 patients), or isolated MPFL reconstruction (Group B, 32 patients). Clinical evaluations were performed 2 years post-operatively and included determination of the number of patients with patellar redislocation, the patellar tilt angle, lateral patellar shift, subjective symptoms, and functional outcomes as evaluated with the Kujala score and Lysholm score.

Results: No dislocation or subluxation occurred during the 25-month follow-up. Radiographically, the patellar tilt angle was 6.0° ± 1.7° in Group A and 6.7° ± 2.0° in Group B, without a significant difference (n. s). The lateral patellar shift was 8.0 ± 2.6 mm in Group A and 8.5 ± 2.4 mm in Group B (n. s). The mean Kujala score was 91.8 ± 3.7 in Group A and 91.5 ± 3.6 in Group B post-operatively (n. s), and the mean Lysholm score was 92.5 ± 3.8 and 90.8 ± 4.9, respectively (n. s).

Conclusions: Double-bundle anatomical MPFL reconstruction with lateral retinaculum plasty is a promising procedure that provides a new option for patellar dislocation.

Level of evidence: III.

Keywords: Lateral retinacular release; Lateral retinaculum; Medial patellofemoral ligament reconstruction; Medial retinaculum; Patellar dislocation.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Male
  • Patella / surgery
  • Patellar Dislocation / surgery*
  • Patellar Ligament / surgery*
  • Patellofemoral Joint / surgery*
  • Plastic Surgery Procedures / methods*
  • Postoperative Period
  • Young Adult