title: Medial patellofemoral ligament reconstruction: a prospective outcome assessment of a large single centre series.
abstract: We report a prospective analysis of clinical   outcome in patients treated with medial patellofemoral ligament   (MPFL) reconstruction using an autologous semitendinosus graft.   The technique includes superolateral portal arthroscopic assessment   before and after graft placement to ensure correct graft tension   and patellar tracking before fixation. Between October 2005 and   October 2010, a total of 201 consecutive patients underwent 219 procedures.   Follow-up is presented for 211 procedures in 193 patients with a   mean age of 26 years (16 to 49), and mean follow-up of 16 months   (6 to 42). Indications were atraumatic recurrent patellar dislocation   in 141 patients, traumatic recurrent dislocation in 50, pain with   subluxation in 14 and a single dislocation with persistent instability   in six. There have been no recurrent dislocations/subluxations.   There was a statistically significant improvement between available pre-   and post-operative outcome scores for 193 patients (all p < 0.001).   Female patients with a history of atraumatic recurrent dislocation   and all patients with history of previous surgery had a significantly   worse outcome (all p < 0.05). The indication for surgery, degree   of dysplasia, associated patella alta, time from primary dislocation   to surgery and evidence of associated cartilage damage at operation   did not result in any significant difference in outcome. This series adds considerably to existing evidence that MPFL   reconstruction is an effective surgical procedure for selected patients   with patellofemoral instability.
authors.affiliation: Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, UK. nickrhowells@yahoo.co.uk
authors.forename: N R
authors.initials: NR
authors.lastname: Howells
authors.forename: A J
authors.initials: AJ
authors.lastname: Barnett
authors.forename: N
authors.initials: N
authors.lastname: Ahearn
authors.forename: A
authors.initials: A
authors.lastname: Ansari
authors.forename: J D
authors.initials: JD
authors.lastname: Eldridge
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology* / Q000601:surgery*; D031221:Knee Dislocation / Q000453:epidemiology; D007718:Knee Injuries / Q000453:epidemiology* / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D057071:Patellofemoral Joint / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012086:Reoperation; D013710:Tendons / Q000637:transplantation; D016896:Treatment Outcome; D055815:Young Adult