Medial patellofemoral ligament reconstruction with a synthetic polyester suture tape graft and knotless anchors: Five-year clinical and functional outcomes.

Abstract

Introduction: Medial patellofemoral ligament (MPFL) reconstruction is a well-established treatment for recurrent lateral patellar dislocations, yielding satisfactory clinical outcomes. Although synthetic materials are not widely used due to limited long-term data, they offer the potential to eliminate donor-site complications and may provide promising results. This study evaluated the five-year clinical and functional outcomes of MPFL reconstruction using suture tape, hypothesising that it is a safe alternative to traditional grafts.

Methods: Thirty patients aged 20 - 45 years with recurrent lateral patellar dislocations were treated between 2017 and 2020. Exclusion criteria included patellofemoral joint pathology, high-grade trochlear dysplasia, patella alta, neuromuscular disorders, or significant lower limb malalignment requiring correction. All patients underwent MPFL reconstruction using suture tape, placed in the superomedial half of the patella and fixed to the femoral footprint using a knotless anchor. The vastus medialis obliquus insertion was advanced laterally and distally. Preoperative assessments included clinical examinations, knee radiographs, alignment views, TT-TG measurements via CT scans, and MRIs. Patients were evaluated using the Kujala scale, International Knee Documentation Committee (IKDC) score, Crosby and Insall grading system, and Lysholm score.

Results: At the 5-year follow-up, all patients had resumed their daily activities without recurrence of dislocation. The mean Kujala score improved from 65.23 to 93.60 (P < 0.001), with significant increases also observed in IKDC and Lysholm scores (P < 0.001). According to the Crosby/Insall grading system, 24 patients were rated as "excellent", and six patients were rated as 'good'. The mean knee extension was -5°, and flexion was 140° at the final follow-up.

Conclusion: MPFL reconstruction using suture tape with knotless anchors, combined with careful patient selection, appears to be a safe and effective option, demonstrating satisfactory five-year clinical outcomes and no recurrence of instability. However, this study was limited by its relatively small sample size and retrospective design.