title: Midterm results of combined patellofemoral and patellotibial ligaments reconstruction in recurrent patellar dislocation.
abstract: OBJECTIVE
  To report the midterm results of mini-invasive anatomical no hardware combined reconstruction of the medial patellofemoral ligament (MPFL) and medial patellotibial (MPTL) using single semitendinosus tendon autograft.
  
  
  METHODS
  A prospective study was performed on 33 cases with recurrent patellar dislocation treated with combined MPFL and MPTL reconstruction by a described Relay Technique. Evaluation was focusing on return to previous level of activity, range of motion, apprehension, overall patient satisfaction and scoring with VAS, Cincinnati, Kujala's, Lysholm scores. Radiological evaluation was based on congruence and tilting angles. Four cases were lost to follow-up and excluded from the study, so the study included 29 patients.
  
  
  RESULTS
  The mean VAS had improved from 6.3 to 1.8. Cincinnati score increased from 50 ± 7.1 (range, 38-60) to 88 ± 6 (range, 76-100). The mean Kujala score increased from 36.6 ± 6 (range, 22-48) to 90.6 ± 7 (range, 78-100). The mean Lysholm score increased from 51.9 ± 4.7 (range, 42-59) to 89.5 ± 5.6 (range, 78-98). The congruence angle improved from 11.93° to -6.48°, and the patellar tilt angle from 10.9° to 2.45°. All improvements were statistically significant. Only one case reported unsatisfaction, and 96.4 % were satisfied and returned to previous activity. No single recurrence was reported.
  
  
  CONCLUSIONS
  Combined anatomical MPFL and MPTL reconstruction with semitendinosus (ST) autograft using mini-invasive Relay Technique is safe, and its midterm results show significant clinical and radiological improvements with 96.4 % patient satisfaction and nil rate of recurrence.
authors: Ain Shams University, 3 Mokhles El Alfy st., Nasr City, Cairo, Egypt. psobsy@gmail.com
authors: Mohamed Hassan
authors: MH
authors: Sobhy
authors: Mahmoud A
authors: MA
authors: Mahran
authors: Ezzat Mohamed
authors: EM
authors: Kamel
mesh_terms: D000328:Adult; D050376:Bone-Patellar Tendon-Bone Grafting / Q000009:adverse effects / Q000379:methods; D004534:Egypt; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000517:prevention & control; D008297:Male; D017888:Medial Collateral Ligament, Knee / Q000000981:diagnostic imaging / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures; D031222:Patellar Dislocation / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D017847:Patellar Ligament / Q000000981:diagnostic imaging / Q000601:surgery; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures; D055502:Secondary Prevention; D014182:Transplantation, Autologous; D016896:Treatment Outcome