As the medial patellofemoral ligament (MPFL) has recently been shown to provide the primary restraint in lateral patellar translation, MPFL reconstruction has become a common procedure. The purpose of this study was to compare the short- and mid-term results of MPFL reconstruction using the gracilis tendon in comparison with the semitendinosus tendon.
We reviewed 29 patients (11 men and 18 women) who underwent MPFL reconstruction with hamstring tendons in our hospital. The mean patient age was 22.9 (range 13 to 40) years and the average follow-up period was 3.48 years (range, 6 months to 8 years 7 months). Among them, 21 patients underwent MPFL reconstruction using the gracilis tendon as a graft (group G), and 8 patients did so using the semi-tendinosus tendon (group ST). Clinical and radiological evaluations were performed in both groups.
The mean Kujala score improved from 55.9 points preoperatively to 96.2 points postoperatively in group G, and from 58.4 points to 96.7 points, in group ST, respectively. Postoperatively, patella apprehension signs became negative in all cases, and no patella dislocations occurred in either group. Furthermore, patellofemoral alignment was improved after surgery in all cases.
Although there were no significant inter-group differences in the average values of any clinical or radiological parameters, the ratio of patients who found it impossible to sit in the Japanese style with the legs folded at 180° was significantly higher in group ST than in group G. This suggests that caution may be necessary for ROM recovery in patients who undergo MPFL reconstruction using the semitendinosus tendon rather than the gracilis tendon.
