Podium (Sports) 12

Medial Patellofemoral Ligament Reconstruction Using a Quadriceps Tendon Autograft - A Case Series

Carlos Miguel B. Santos, MD; Carmelo L. Braganza, MD, FPOA University of Santo Tomas Hospital

Introduction: Medial patellofemoral ligament (MPFL) reconstruction is widely used for the treatment of patellar instability. There are various methods and surgical techniques that have been used, most especially using hamstring autografts and the use of patellar bone tunnels.

Objectives: For this case series, the authors focused on the use of a quadriceps tendon autograft in the restoration of the primary ligamentous stabilizer preventing lateral patellar dislocation. The aim of the study was to examine the functional and patient-reported outcome measures up to twelve (12) months after the operation.

Methods: Ten patients were included in this study. The MPFL was reconstructed using a quadriceps autograft tendon. The patients were evaluated clinically through examining the knee range of motion and they were made to complete patient-reported outcome measures, more specifically, the Tegner, Lysholm and Kujala scores pre-operatively and at 3, 6 and 12 months, post-operatively. Patient demographics were also included for this study.

Results: The mean Lysholm score improved from a pre-operative mean score of 68.3 ± 13.7 to 78.6 ± 8.18 at 3 months, 88.4 ± 6.26 at 6 months and 91 ± 4.83 at 12 months post-operatively. The Tegner score increased from a pre-operative mean level of 3.4 ± 1.11 to 5.5 ± 1.20 at 3 months, 7.3 ± 1.27 at 6 months and 7.6 ± 0.82 at 12 months post-operatively. The Kujala score showed improvement from a pre-operative mean score of 67.3 ± 12.67 to 80.3 ± 5.68 at 3 months, 88.5 ± 4.74 at 6 months and 93.89 ± 3.12 at 12 months post-operatively. Knee range of motion improved post-operatively for most patients with one reported re-dislocation at 7 months post-operation.

Conclusion: Medial patellofemoral ligament reconstruction using a quadriceps tendon autograft shows promising clinical and functional results as an alternative surgical technique to the more common use of hamstring tendon autograft.