title: Complications of medial patellofemoral ligament reconstruction in young patients.
abstract: BACKGROUND
  The medial patellofemoral ligament (MPFL) has been recognized as the primary restraint to lateral subluxation of the patella. Reconstruction of the MPFL for patellar instability has demonstrated early clinical success, but postoperative complications have rarely been reported, especially in young patients.
  
  
  OBJECTIVE
  To assess early complications (<3 years) of MPFL reconstruction in young patients.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  The charts and radiographs of all patients who underwent MPFL reconstruction between 2005 and 2011 were retrospectively reviewed to identify postoperative complications. A complication was considered major if the patient required hospitalization or further surgery. Each complication was analyzed to identify the technical factors related to it.
  
  
  RESULTS
  A total of 179 knees underwent MPFL reconstruction during the study period. There were 38 complications in 29 knees (16.2%), with 34 major and 4 minor. Major complications included recurrent lateral patellar instability (8 patients), knee motion stiffness with flexion deficits (8 patients), patellar fractures (6 patients), and patellofemoral arthrosis/pain (5 patients). Eighteen of 38 (47%) complications were secondary to technical factors and were considered preventable. Female sex and bilateral MPFL reconstructions were risk factors associated with postoperative complications.
  
  
  CONCLUSIONS
  Complications occurred in 16.2% of MPFL reconstruction surgeries for patellar instability in young patients, with almost half resulting from technical problems. Patients should be counseled preoperatively on the risk of potential complications.
authors.affiliation: Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 2017, Cincinnati, OH 45229, USA. shital.parikh@cchmc.org
authors.forename: Shital N
authors.initials: SN
authors.lastname: Parikh
authors.forename: Senthil T
authors.initials: ST
authors.lastname: Nathan
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Wall
authors.forename: Emily A
authors.initials: EA
authors.lastname: Eismann
mesh_terms: D000293:Adolescent; D000328:Adult; D018771:Arthralgia / Q000209:etiology; D001178:Arthroplasty / Q000009:adverse effects*; D002648:Child; D005260:Female; D005269:Femur; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D007593:Joint Instability / Q000517:prevention & control / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D019300:Medical Errors / Q000009:adverse effects*; D010329:Patella / Q000293:injuries*; D016059:Range of Motion, Articular; D012008:Recurrence; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult
keywords: MPFL; complications; instability; knee; patella