The docking technique for medial patellofemoral ligament reconstruction: surgical technique and clinical outcome.

BACKGROUND

Current techniques of medial patellofemoral ligament (MPFL) reconstruction vary with respect to methods of fixation on the femur and the patella. This article presents the outcomes of a surgical technique for reconstruction of the MPFL that uses a soft tissue graft with interference screw fixation on the femur and a docking technique for fixation on the patella.

HYPOTHESIS: Patients with patellar instability who are treated with the docking technique for MPFL reconstruction will have improvements in knee symptoms and function, with a high percentage achieving good to excellent results at early follow-up.

STUDY

DESIGN

Case series; Level of evidence, 4.

METHODS

Twenty consecutive patients with patellar instability underwent reconstruction of the MPFL. Patients were evaluated preoperatively and postoperatively by physical and radiographic examination and subjectively with the IKDC (International Knee Documentation Committee), Tegner, Kujala, and Lysholm questionnaires. Nineteen patients underwent magnetic resonance imaging preoperatively.

RESULTS

The average follow-up was 31 months (range, 24-39). No recurrent episodes of dislocation or subluxation were reported. A firm endpoint to lateral patellar translation was noted in all patients at most recent follow-up. The IKDC subjective knee evaluation score improved from 42 preoperatively to 82 postoperatively (P < .001); Kujala, from 50 to 88 (P < .001); Lysholm, from 50 to 89 (P < .001); and Tegner, from 3.6 to 5.6 (P < .001).

CONCLUSION

The docking technique for MPFL reconstruction is an effective surgical procedure for the treatment of patellar instability.