Reimagined MPFL Reconstruction: Retinacular fixation of the doubled hamstring graft at the patella and suture anchor-based femoral fixation

Background. Lateral patellar dislocation is frequently observed among
teenagers and young adults. There is no consensus on the best type of
graft or fixation strategy for the femur and patella, and complications
such as iatrogenic patella fracture, tunnel malposition, and grafting
failure are common. The objective of our research is to outline a new
method of medial patellofemoral ligament (MPFL) reconstruction, which
involves two key components: (1) Patellar fixation is accomplished by
suturing the two limbs of the looped doubled hamstring graft in a
divergent fashion to the retinaculum at the medial border of the upper
half of patella and, (2) the placement of a suture anchor tied to the
graft at the isometric point on the medial femur condyle. Methods. This
study is a retrospective assessment of patients who underwent MPFL
reconstruction at our hospital during the period between September 2018
and August 2020. Patients were monitored for at least 2 years after the
initial procedure until August 2022. Results. A total of 29 patients were
recruited for the study, with 22 being females and the average age being
30.38 years. During the postoperative period, none of the participants
experienced instability, re-dislocation, or patellar/femoral fractures.
The Tegner-Lysholm Knee Score was good to excellent for 17 (58.6%)
participants, fair for 10 (34.5%) participants, and poor for 2 (6.9%)
participants. The Kujala Anterior Knee pain score was more than 80 for 19
(65.5%) participants. No cases of abnormal growth were reported during a
follow-up period of 30.6 months. Conclusion. The outcomes observed with
this technique in terms of function were comparable to those reported with
alternative surgical methods.