Synthetic suture tape for medial patellofemoral ligament reconstruction is an effective treatment for complex paediatric patellofemoral instability

María Galán-Olleros; Pablo Arviza-Lorenzo; Carlos Miranda-Gorozarri; Javier Alonso-Hernández; Paloma Manzarbeitia-Arroba; Ana Ramírez-Barragán; Ángel Palazón-Quevedo

doi:10.1002/ksa.12260

Synthetic suture tape for medial patellofemoral ligament reconstruction is an effective treatment for complex paediatric patellofemoral instability

Knee Surg Sports Traumatol Arthrosc. 2024 May 15. doi: 10.1002/ksa.12260. Online ahead of print.

Authors

María Galán-Olleros¹, Pablo Arviza-Lorenzo², Carlos Miranda-Gorozarri¹, Javier Alonso-Hernández¹, Paloma Manzarbeitia-Arroba¹, Ana Ramírez-Barragán¹, Ángel Palazón-Quevedo¹

Affiliations

¹ Pediatric Orthopaedic, Orthopaedic Surgery and Traumatology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
² Orthopaedic Surgery and Traumatology Department, Hospital Universitario de Getafe, Madrid, Spain.

PMID: 38746987
DOI: 10.1002/ksa.12260

Abstract

Purpose: To assess the outcomes of medial patellofemoral ligament (MPFL) reconstruction using synthetic suture tape in paediatric patients with patellofemoral instability (PFI).

Methods: This ambispective comparative study, conducted from 2014 to 2022, included paediatric patients who underwent MPFL reconstruction with synthetic suture tape and had a minimum follow-up of 1 year. Pre- and postoperative clinical and functional outcomes, patient satisfaction and complications were assessed.

Results: The study comprised 22 patients (29 knees), with a median age at surgery of 14.4 years (interquartile range [IQR] 10.9-16.7) and a median follow-up of 46.5 months (24.7-66). Notably, 13 knees (44.8%) had open growth plates at the time of surgery. The cohort included patients with Down syndrome (3 patients), Ehlers-Danlos (2), arthrogryposis (1), generalized joint hypermobility (8) and previous unsuccessful PFI surgeries (8). Concomitant procedures were performed on 16 knees. Postoperatively, improvements were observed in all but one patient, who reported residual pain. There were two other complications: one suture-tape rupture and one surgical wound infection. Functional scores significantly improved: Kujala, +14 points (7-29) (p < 0.001); IKDC, +10.5 points (5.2-25.3) (p < 0.001); Tegner, +2 points (0-4) (p < 0.001); Lysholm, +15 points (0-37.5) (p < 0.001). Most patients achieved excellent outcomes by Crosby-Insall criteria (21 patients, 72.4%) and reported high satisfaction (23 patients, 79.3%).

Conclusions: MPFL reconstruction using synthetic suture tape is a viable and effective treatment for paediatric patients with PFI, particularly for those with connective tissue disorders, generalized joint hypermobility or past surgical failures, significantly enhancing clinical and functional outcomes with an acceptable complication rate.

Level of evidence: Level IV.

Keywords: Internal ligament bracing; ligament reconstruction; medial patellofemoral ligament; patellofemoral instability; suture tape; synthetic material.

Grants and funding

None