DOS 2016

DOS Kongressen 2016 ·

135

Comparison of soft tissue and bone graft fixation for

reconstruction of the medial patellofemoral ligament.

A randomized controlled trial.

Martin Lind, Peter Faunø, Ole Gade Sørensen, Bjarne Mygind-Klavsen, Lene

MIller, Thorsten Nielsen

Orthopedics, Århus University Hospital; Orthopedics, Århus University Hospital

Background:

Medial patellofemoral ligament reconstruction (MPFL-R) has re-

cently been accepted as the primary surgical treatment for patella instability.

Limited knowledge exists concerning which reconstruction technique that gives

the best clinical outcome and the least surgical morbidity.

Purpose / Aim of Study:

The present study compares clinical outcome and

surgical morbidity after MPFL- R with either bone (standard technique) or soft

tissue femoral graft fixation in a randomized controlled study.

Materials and Methods:

60 patients were randomized to two MPFL- R tech-

niques: Bone or soft tissue fixation of the graft at the femoral condyle. Patients

were operated between 2010 and 2015. Indication for surgery was two or

more patella dislocations. Surgical technique bone fixation: Gracilis tendon fixed

in a bone tunnel with interference screw. Surgical technique soft tissue fixation.

Gracilis tendon was looped around the adductor magnus tendon. Both tech-

niques had patella graft fixation with drillholes in the medial patella edge. Clinical

outcome were evaluated with Kujala, KOOS and NRS pain scores preoperatively

and at 1-year follow-up. Surgical morbidity was evaluated by pain at palpation

along the reconstruction.

Findings / Results:

Kujala score was 83 and 84 for bone and soft tissueMPFL-R

respectively with no difference between groups. No differences on KOOS and

pain scores were found. Surgical morbidity analysis demonstrated that 13 and

12 % had significant palpable pain at the reconstruction for bone and soft tissue

MPFL-R respectively. There were no patella redislocations in both groups.

Conclusions:

MPFL-R with soft tissue femoral fixation results in similar subjec-

tive clinical outcome, patella stability and pain levels as bone fixation. Surgical

morbidity was also similar between soft tissue and bone fixation MPFL-R.

No conflicts of interest reported

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