Isolated medial patellofemoral ligament reconstruction significantly improved quality of life in patients with recurrent patella dislocation
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The purpose of this study was to measure the improvement in quality of life (QoL) following isolated anatomical double-bundle medial patellofemoral ligament reconstruction.
This is a single-centre, prospective study of 56 consecutive patients (57 knees) who underwent isolated MPFL reconstruction between 2014 and 2017. Functional outcome and QoL were assessed with the Kujala score and the EQ-5D-3L questionnaire, respectively. Objective outcomes were obtained through clinical examination at the latest follow-up assessing redislocation rate, patella apprehension test, patellar tilt, pain and range of motion.
The median Kujala score increased from 60 (range 31–96) to 92 (range 34–100) at latest follow-up (p < 0.001). The median EQ-5D index also increased, from 0.69 (range 0.10–1) at baseline to 1 (range 0.16–1) at latest follow-up (p < 0.001), as well as the median EQ-5D VAS from 75 (range 20–95) to 92 (range 40–100) (p < 0.001). Four dimensions of the EQ-5D were significantly improved except for the anxiety/depression scores. Female patients reported lower scores at baseline and at latest follow-up, for all three outcomes (Kujala, EQ-5D index, EQ-5D VAS), however there was no evidence that gender negatively impacted on the benefit of surgery. The re-dislocation rate was 0%. Apprehension and patellar tilt test were negative in all patients and no flexion deficit was identified at latest follow-up. Two patients had tenderness along the reconstruction requiring femoral screw removal in one of them.
Isolated anatomical double-bundle aperture MPFL reconstruction, offered significantly improved short-term QoL along with excellent functional outcome. Female patients scored lower, but this did not affect the overall outcome. Including QoL tools in the assessment of ligament reconstruction operations, such as the MPFL, can provide more accurate understanding of the overall patient benefit.
Level of evidence
KeywordsMedial patellofemoral ligament reconstruction Quality of life Double-bundle anatomical aperture fixation
We are grateful to the statistician Mr. Herman Yan Kuiper, for conducting the statistical analysis of this study. Without his help this paper would have not been submitted.
The authors confirm that no funding was received for this study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained verbally from all patients.
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