A systematic review of complications and failures associated with medial patellofemoral ligament reconstruction for recurrent patellar dislocation.
BACKGROUND
Patellofemoral instability affects activities of daily living and hinders athletic participation. Over the past 2 decades, more attention has been paid to medial patellofemoral ligament (MPFL) reconstruction for the treatment of recurrent patellar dislocations/subluxations. Numerous techniques have been reported; however, there is no consensus regarding optimal reconstruction.


OBJECTIVE
This study sought to report on the various techniques for MPFL reconstruction described in the literature and to assess the rate of complications associated with the procedure.


METHODS
Meta-analysis.


METHODS
A systematic review of the literature was performed in early October 2010 using keywords "medial patellofemoral ligament," "MPFL," "reconstruction," "complication(s)," and "failure(s)." Articles meeting the inclusion criteria were reviewed. Graft choice, surgical technique, outcome measures, and complications were recorded and organized in a database. Descriptive statistical analysis was performed on the data collected.


RESULTS
Twenty-five articles were identified and reviewed. A total of 164 complications occurred in 629 knees (26.1%). These adverse events ranged from minor to major including patellar fracture, failures, clinical instability on postoperative examination, loss of knee flexion, wound complications, and pain. Twenty-six patients returned to the operating room for additional procedures.


CONCLUSIONS
Medial patellofemoral ligament reconstruction has a high rate of success for patients with patellofemoral instability; however, the complication rate of 26.1% associated with this procedure is not trivial. This study quantified complications and documented the variety of complications reported in outcomes-based literature.
University of Kentucky, Department of Orthopaedic Surgery and Sports Medicine, 740 South Limestone, K435, Lexington, KY 40536, USA.
Jay N
JN
Shah
Jennifer S
JS
Howard
David C
DC
Flanigan
Robert H
RH
Brophy
James L
JL
Carey
Christian
C
Lattermann
D006801:Humans; D019637:Orthopedic Procedures / Q000009:adverse effects*; D031222:Patellar Dislocation / Q000150:complications / Q000601:surgery*; D017847:Patellar Ligament / Q000293:injuries* / Q000601:surgery*; D057071:Patellofemoral Joint / Q000293:injuries* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D012008:Recurrence