Patient-Reported Favorable Outcomes of a Minimum Five-Year Follow-Up After Medial Patellofemoral Ligament (MPFL) Reconstruction: A Systematic Review and Meta-Analysis.

Medial patellofemoral ligament (MPFL) reconstruction is a procedure performed to address patellofemoral instability. The primary objective of this paper is to evaluate studies reporting the outcomes of MPFL reconstruction at a minimum five-year follow-up through analysis of patient-reported outcomes (PROs), re-dislocations, and range of motion. We hypothesize that MPFL reconstruction will demonstrate excellent PROs, low redislocation rates, and full range of motion. A search following guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed in three databases on March 23, 2024: PubMed, Embase, and the Cochrane Library. The query was performed utilizing the Boolean search phrase "(Medial patellofemoral ligament reconstruction OR MPFL reconstruction). There were no restrictions set to the search. Studies were included if they reported on outcomes of MPFL reconstruction at a minimum follow-up of five years. Twelve studies published between 2007 and 2023, containing 498 patients and 521 knees were included with a mean follow-up period of 98 months (60-215). Autologous gracilis grafts were the most common source used for MPFL reconstruction. Statistically significant improvements were found in preoperative to postoperative Kujala, Lysholm, and Tegner scores (p < 0.001). The overall re-dislocation rate across all studies was 5.75%, and the reoperation rate was 0.38%. MPFL reconstruction demonstrates excellent PROs with low redislocation rates at a minimum five-year follow-up and can be safely considered in patients with patellar instability.