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Medial patellofemoral ligament (MPFL) reconstruction using quadriceps tendon autograft provides good clinical, functional and patient-reported outcome measurements (PROM): a 2-year prospective study

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The medial patellofemoral ligament (MPFL) is the most important ligamentous stabilizer preventing lateral patella dislocation. Numerous surgical procedures for MPFL reconstruction have been described in the literature. The aim of this study was to investigate the clinical, functional and patient-reported (PROM) outcomes 2 years after minimally invasive MPFL reconstruction performed using an autologous strip of the quadriceps tendon.

Methods

Thirty-six patients (38 knees) were included in the study. For MPFL reconstruction, a partial thickness autologous quadriceps tendon graft was used. All patients were evaluated clinically and with patient-reported outcome questionnaires including the Tegner, Lysholm and Kujala scores as well as a visual analogue scale (VAS) for pain preoperatively and at 6, 12 and 24 months postoperatively. A functional Back-in-Action (BIA) test battery, including a total of seven stability, agility and jumping tests, was performed on 19 (50%) patients at the final follow-up. One patient was lost to follow-up at 24 months.

Results

The mean age at the time of operation was 25.2 ± 6.1 years. No redislocations occurred during the period of investigation. The mean Lysholm score improved significantly from 79.3 ± 16.1 preoperatively to 83.2 ± 14.4 at 6 months, 88.1 ± 11.3 at 12 months and to 90.0 ± 9.6 at 24 months follow-up. No change throughout the study period was observed for the median Tegner Activity Score (median 6). The mean Kujala score increased from a preoperative value of 82.0 ± 12.4, to 84.5 ± 8.4 at 6 months, and 88.2 ± 5.8 at 12 months up to 88.7 ± 4.5 at 24 months follow-up. A total of 77.8% of the performed functional BIA tests were equal to or above the norm for patients of the corresponding ages and activity levels.

Conclusions

Minimally invasive MPFL reconstruction with a partial thickness strip of quadriceps tendon is a safe and effective treatment for patellofemoral instability. Good clinical, functional and subjective results were observed at the 2-year follow-up.

Level of evidence

Prospective cohort study, non-randomized, Level IV.

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Authors and Affiliations

  1. Gelenkpunkt, Sports and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria

    Peter Gföller, Christian Hoser, Armin Runer, Elisabeth Abermann & Christian Fink

  2. Department for Trauma Surgery and Sports Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Armin Runer

  3. Department of Orthopaedics and Traumatology, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020, Salzburg, Austria

    Guido Wierer

  4. Research Unit of Orthopedic Sports Medicine and Injury Prevention, Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria

    Christian Fink

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  1. Peter Gföller
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  2. Christian Hoser
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  3. Armin Runer
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  4. Elisabeth Abermann
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  6. Christian Fink
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Corresponding author

Correspondence to Armin Runer.

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Conflict of interest

Christan Fink receives royalties from Karl Storz and consultancies from Karl Storz, Medacta and Zimmer BioMed. All other authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained written and verbally from all participants included in the study.

Ethical approval

The study was approved by the ethics committee of the Medical University of Innsbruck (AN2015-0050).

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Peter, G., Hoser, C., Runer, A. et al. Medial patellofemoral ligament (MPFL) reconstruction using quadriceps tendon autograft provides good clinical, functional and patient-reported outcome measurements (PROM): a 2-year prospective study. Knee Surg Sports Traumatol Arthrosc 27, 2426–2432 (2019). https://doi.org/10.1007/s00167-018-5226-6

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  • DOI: https://doi.org/10.1007/s00167-018-5226-6

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