Simultaneous ACL and Patellofemoral Instability: Surgical Management and Outcomes

The study discussed three patients who experienced both anterior cruciate ligament (ACL) injury and patellofemoral instability. This combination of injuries is rare and has a scarcity of published /literature. The study described the mechanism of injury, diagnostic modalities, and the decision-making process for surgical intervention. It emphasizes the importance of a comprehensive clinical evaluation and discusses surgical techniques for combined ACL and medial patellofemoral ligament (MPFL) reconstruction. The study suggests that with careful evaluation and meticulous surgical techniques, patients with concurrent ACL and MPFL injuries can achieve successful outcomes and return to normal activities.

The cases presented involve young patients who suffered twisting knee injuries, often resulting from accidents or sporting activities. The surgical technique involved the use of grafts for ACL and MPFL reconstruction. MPFL reconstruction was performed followed by ACL reconstruction. Post-operative rehabilitation included the use of a patellar stabilizing knee brace and gradual mobilization.

The patients experienced moderate pain initially but achieved a full range of motion and stability in the knee after several weeks. At the 1-year follow-up, both patients reported no symptoms of instability or pain.

The article highlights the importance of MPFL reconstruction in preventing ACL reconstruction failures and emphasizes the need for aggressive rehabilitation to prevent knee stiffness. Overall, this study presented important information and added knowledge regarding the diagnosis, surgical management, and post-operative care of patients with concurrent ACL and patellofemoral instability.