Medial patellofemoral ligament reconstruction with semitendinosus autograft for chronic patellar instability: a follow-up study.
OBJECTIVE
The purpose of this study was to describe the long-term results of medial patellofemoral ligament reconstruction with a free semitendinosus graft.


METHODS
Prospective nonrandomized study.


METHODS
We assessed 15 patients (16 knees) treated between 1992 and 1996 (follow-up > 5 years). Diagnosis of patellofemoral dislocation or subluxation was based on the patient's report plus reproduction of subjective complaints of instability on physical examination. All patients were treated by the same surgeon. Assessment was performed by a different surgeon based on Crosby-Insall and Aglietti criteria.


RESULTS
According to Crosby-Insall criteria, 11 knees were rated as excellent, 4 good, and 1 poor. According to Aglietti criteria, 11 knees were rated as excellent, 3 good, 1 fair, and 1 poor. According to both protocols, 15 knees showed negative apprehension test, absence of patellofemoral pain, and normal patellar tracking. In one knee, the apprehension test was positive, patellofemoral pain was present, and patellar tracking was abnormal. Patellofemoral crepitus was detected in 10 knees (attenuated in 6). Thirteen patients (14 knees) were satisfied with the results. One patient considered the result acceptable, but below expectations. The final patient underwent an additional procedure. No cases of infection and no vascular problems were seen.


CONCLUSIONS
Medial patellofemoral ligament reconstruction proves to be useful in improving unstable extension mechanisms and in preventing insecurity, gradual joint deterioration, and disabling pain during dislocation episodes, in a minimal 5-year follow-up study.


METHODS
Level IV.
Ellera Gomes
Joäo Luiz
JL
Department of Surgery, Medical School of the Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil. joelgo.voy@terra.com.br
Stigler Marczyk
Luiz Roberto
LR
César de César
Paulo
P
Jungblut
Carlos Francisco
CF
D000328:Adult; D001182:Arthroscopy; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D007593:Joint Instability / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D017847:Patellar Ligament / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D013710:Tendons / Q000637:transplantation; D014182:Transplantation, Autologous