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Minimal Invasive Medial Patellofemoral Ligament Reconstruction by Hamstring Tendon Auto-graft

Ahmed Hashem Amin* and Mohamed Hamed Fahmy

Study design: Retrospective study.
Objective of the study: The objective of this study was to evaluate the results of minimal invasive patellofemoral ligament reconstruction via two small incisions in cases of recurrent dislocation of the patella.
Background: Patellar dislocation is one of the problems encountered in orthopedic practice. The annual incidence is 78 in 100,000. Most of the patients are adolescents and young adults. The medial patellofemoral ligament is the most important static stabilizer of the patella in extension.
Patients and methods: This study included 8 patients who were consecutively operated on. Patients underwent surgery from May 2011 to June 2012. Mean follow-up was 24 months. The patients’ median age was 22 years (range, 18 to 32 years). There were 5 males and 3 females patients. All patients had chronic patellar instability with a minimum of 2 times total patellar dislocations. Semitendinosus tendon was harvested and prepared. Patellar and femoral tunnels were drilled through two small skin incisions. The graft was fixed to the patella by interference screw then extra synovial passage of the graft was created between the patellar and femoral incisions. The graft was fixed to the femur by interference screw.
Results: The median follow-up was 24 months. The Kujala knee function score improved overall from 46 points (range, 12 to 67 points) to 84 points (range, 62 to 100 points) at 24 months follow-up.
Conclusions: Minimal invasive medial patellofemoral ligament reconstruction by semitendinosus tendon autograft and single patellar tunnel technique is effective, reproducible and reliable method for the treatment of lateral patellar instability.