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DOS Kongressen 2017 ·
143
Lateral Patellar Instability Treated by Non-Anatomic
Functional Reconstruction of the Medial Patellofemo-
ral Ligament Using the Medial Collateral Ligament of
the Knee as a Pulley
Jens-Christian Beuke, Jens Christian Pörneki, Jesper Vinther, Niels Maagaard,
Bjarke Viberg
Department of Orthopaedic Surgery and Traumatology, Kolding Hospital – part
of Lillebælt Hospital
Background:
In surgical treatment of lateral patellar instability, the reconstruc-
tion of the medial patellofemoral ligament (MPFL) has become a gold standard
to re-establish the medial soft tissue’s strength in restraining lateral patella dis-
placement.
Purpose / Aim of Study:
The study investigates the outcomes of a novel op-
erative method for non-anatomic functional MPFL recon-struction using the
medial collateral ligament (MCL) as a pulley.
Materials and Methods:
The cohort consisted of 149 patients (160 knees)
with lateral patellar instability, who underwent MPFL re-construction with the
MCL pulley from 2010 to 2015 at Kolding and Odense. Patient records were
reviewed retrospectively and a questionnaire study registered patient answers
(n = 104; 69.8 %) for the following patient-reported outcome measures: Kujala
and Tegner-Lysholm knee scoring scales, EuroQol EQ-5D-3L, and other rel-
evant aspects. Non-parametric statistics were performed due to non-Gaussian
distribution.
Findings / Results:
89.4 % of the 160 knee operations had a postoperative
course without problems; for 5.0 % and 5.6 % knees minor or major postop-
erative complications were found respectively. Medial knee tenderness after 6
weeks was registered for 12.5 % of the knees. With an interquartile range (IQR)
of 68-91, the median Kujala score was estimated to 81, whilst the Tegner-
Lysholm score was 87 (IQR: 74-94). The EQ-5D-3L showed to be 0.84 (IQR:
0.78-1.0). None of the patients characterised their operation as poor, 3.1 %
re-ported it as fair, and 96.1 % had a well to excellent result from their opera-
tion. Compared to pre-surgery, 2.5 % described a worse knee outcome. 8.2 %
no difference and 89.3 % had a better outcome.
Conclusions:
Using the MCL pulley in functional reconstruction of the MPFL
seems promising with low rate of complica-tions and little or no medial tender-
ness after 6 weeks.
No conflicts of interest reported
95.