Medial Patellofemoral Ligament Reconstruction: Patient-Reported Outcome Measures Comparing Autograft and Allograft Tendons with or Without Tibial Tubercle Osteotomy.

Objectives

To compare patient-reported outcome measures (PROMS) as the primary outcome following medial patellofemoral ligament reconstruction (MPFLR) using autograft versus allograft tendon. Secondary objectives were to assess re-dislocation rates and evaluate the effect of concomitant tibial tubercle osteotomy (TTO) on PROMs.

Methods

Eighty-eight patients from two fellowship-trained orthopaedic surgeons operating at a single institution between 2018 and 2023 were identified. Eligible patients, including those who had undergone an MPFLR with either autograft or allograft +/- TTO, were contacted to complete three validated surveys to quantify PROMS: the Kujala Anterior Knee Pain Score (Kujala), the Marx Activity Score (Marx), and the Norwich Patellar Instability Score (NPI). Exclusion criteria included musculoskeletal or collage disorders and incomplete PROMs. Re-dislocation rates and PROMS were compared between autograft and allograft groups. Independent samples t-tests were used, with p < 0.05 considered statistically significant.

Results

A total of fifty-nine patients (46% male, average age 28.5 years old) representing 63 knees returned PROMs. All Kujala scores were similar between groups. Subgroup analysis revealed that patients who received an isolated MPFLR compared to those who received an MPFLR with TTO had lower NPI scores: 22.89% versus 30.21% (p < 0.001), respectively. Those who underwent isolated MPLFR with autograft compared to allograft had lower Marx scores: 7.40 versus 7.70 (p = 0.031), respectively. One patient who underwent an allograft experienced a recurrence of their patellar instability.

Conclusions

There was a low recurrent patella dislocation rate following MPFLR and similar anterior knee pain scores in our study when comparing autograft with allograft.