Modern synthetic material is a safe and effective alternative for medial patellofemoral ligament reconstruction

Knee Surg Sports Traumatol Arthrosc. 2018 Sep;26(9):2716-2721. doi: 10.1007/s00167-017-4711-7. Epub 2017 Sep 19.

Abstract

Purpose: Medial patellofemoral ligament (MPFL) reconstruction is often performed using gracilis autografts, which may be associated with donor site morbidity and complications. The use of a synthetic material can circumvent a harvest operation and has previously been demonstrated to be effective in other types of reconstructive procedures and may be effective in MPFL reconstruction. This study reports the clinical result with the use of a modern ultra-high molecular weight polyethylene with a braided jacket of polyester tape (FT) in MPFL reconstruction compared to using standard autografts.

Methods: Data were collected prospectively in 50 MPFL reconstructions. The first 27 underwent reconstruction using gracilis tendon (GT) autograft; the following 23 patients were treated with FT. All patients were clinically and radiologically assessed and underwent pre- and post-operative scoring using the Kujala score, Bartlett score, Tegner activity rating scale, SF-12 score and Lysholm score. Statistical significance was tested between groups using ANOVA with repeated measures.

Results: There were no significant differences in the pre-operative scores between the FT and GT groups (n.s.). Both groups showed significant improvements across all scoring modalities between pre- and post-operative periods 12, 24 and 48 months of follow-up (p < 0.05). There were no significant differences in knee function scores between the GT and FT groups.

Conclusion: The use of FiberTape in MPFL reconstruction is safe and effective, and it significantly improves patient's quality of life and related post-operative outcome measures. There were no significant differences in all knee scores compared to GT autografts. Using this technique for MPFL reconstruction, tendon harvesting is unnecessary and hence eliminates donor site morbidity-associated complications.

Level of evidence: II.

Keywords: FiberTape; Knee; Ligaments; MPFL; Patella.

MeSH terms

  • Biocompatible Materials
  • Female
  • Gracilis Muscle / transplantation
  • Humans
  • Ligaments, Articular / surgery*
  • Male
  • Patellar Dislocation / surgery*
  • Patellofemoral Joint / surgery*
  • Plastic Surgery Procedures / methods*
  • Polyesters
  • Polyethylenes
  • Prosthesis Implantation
  • Quality of Life
  • Recurrence
  • Tendons / transplantation
  • Transplantation, Autologous
  • Young Adult

Substances

  • Biocompatible Materials
  • Polyesters
  • Polyethylenes
  • ultra-high molecular weight polyethylene