title: Medial patello-femoral ligament (MPFL) reconstruction using suture anchors fixation: preliminary results.
abstract: OBJECTIVE
  several surgical techniques have been described for the MPFL reconstruction, using many femoral and patellar fixation techniques and different grafts (autograft, allograft, synthetic). The goal of our study is to evaluate the safety and efficacy of MPFL reconstruction using Juggerknot™ (BIOMET, Warsaw, Indiana) suture anchors fixation with a clinical evaluation pre/post surgery of our patients with objective patellofemoral (PF) instability.
  
  
  METHODS
  from January 2013 to March 2015, 19 patients underwent isolated MPFL reconstruction using Juggerknot™ (BIOMET, Warsaw, Indiana) suture anchors fixation. All patients were operated by the same surgeon using the same technique. Patients were evaluated by the same operator during pre surgery phase and at least at 6 months of follow up, using clinical evaluation (apprehension sign, patellar glide test, ROM) and 4 different scores (Tegner, Vas, Lysholm, Kujala). The possible complications and dislocation following surgery were investigated.
  
  
  RESULTS
  no patellar dislocation and complications were found at follow up. A clinical evaluation improvement was recorded at follow up: all patients achieved a full range of knee motion; apprehension sign from 89% positivity (17 cases) decreased up to 11% (2 cases); glide test from 100% (19 cases) positivity decreased up to 0% (0 cases). Median VAS score decreased significantly (p<0.05) from a median pre-operative value of 8 (min:5 max:10) to 2 (min:0 max:7). Mean Kujala score improved significantly (p<0.05) from 65.23 ± 18.64 pre-operatively to 94.69 ± 6.40. Mean Lysholm score improved significantly (p<0.05) from 64.30 ± 19.29 pre-operatively to 94.72 ± 4.02. Mean Tegner score decreased from 6.15 ± 1.06 pre-operatively to 5.69 ± 0.85.
  
  
  CONCLUSIONS
  in this preliminary study, a clinical assessment of patients undergoing surgery with the Juggerknot ™ (BIOMET, Warsaw, Indiana) suture anchor fixation in MPFL reconstruction, has shown promising results, revealing easy to apply, effective and safe for patients.
authors.affiliation: Department of knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Calanna
authors.affiliation: Department of knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Pulici
authors.affiliation: Department of knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Carimati
authors.affiliation: Department of knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Quaglia
authors.affiliation: Department of knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Volpi
keywords: MPFL reconstruction; knee; patellar instability; suture anchors