Complication Rates After Medial Patellofemoral Ligament Reconstruction Range From 0% to 32% With 0% to 11% Recurrent...

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomechanics

Background:

• Recurrent patellar instability often necessitates surgical intervention.
• Medial patellofemoral ligament (MPFL) reconstruction is a common procedure to address this instability.
• Understanding the complication profile of primary MPFL reconstruction is crucial for patient management and surgical technique refinement.

Approach:

• A systematic literature search was performed using PubMed and Scopus databases.
• Studies published up to August 2022 were included if they reported complications following primary MPFL reconstruction for recurrent patellar instability.
• Data on complication incidence were aggregated and analyzed according to PRISMA guidelines.

Key Points:

• The overall complication rate ranged from 0% to 32.3% across 28 studies involving 1,478 patients.
• Persistent anterior knee pain was the most frequent complication, reported in up to 32.3% of cases.
• Patellar fractures occurred in 0% to 8.3% of knees, predominantly with full-length transverse or 2-tunnel techniques using tunnels of 4.5-6.0 mm diameter.

Conclusions:

• Primary MPFL reconstruction is associated with a variable complication rate, with residual anterior knee pain being the most common.
• Specific surgical techniques, such as full-length transverse or 2-tunnel approaches with larger diameter patellar tunnels, are linked to a higher incidence of patellar fractures.
• Surgeons should consider these findings when selecting techniques for MPFL reconstruction to minimize potential complications.