Medial Patellofemoral Ligament Reconstruction with Quadriceps Tendon Autograft and Double Bundle Semitendinosus...

Patellar dislocations often result in damage to the medial patellofemoral ligament (MPFL), a key stabilizer preventing lateral patellar translation. Various reconstruction techniques, including semitendinosus (ST) and quadriceps tendon (QT) autografts, have been developed to restore stability, with QT emerging as a promising option due to lower risk of complications. We aimed to compare the functional outcomes of patients who underwent MPFL reconstruction using double bundle ST autograft and those who underwent reconstruction using partial QT autograft. Patients who underwent MPFL reconstruction at our institution between January 2018 and January 2023 were retrospectively reviewed. The inclusion criteria were patients with a history of at least two patellar dislocations, a follow-up period of more than 24 months, positive preoperative patellar apprehension, traumatic dislocations, and no prior surgical history on the same knee. Two groups were formed based on the used graft type for reconstruction: a partial QT and ST groups. At the final follow-up, visual analog scale (VAS), Kujala patellofemoral pain score, Lysholm knee score, Tegner activity index, IKDC score, and Crosby-Insall grading system parameters were evaluated. A total of 40 patients (23 QT, 17 ST) were included. Based on the Crosby-Insall grading system, the QT group had 17 excellent, 5 good, and 1 poor result, while the ST group had 8 excellent, 7 good, and 2 poor results (p = 0.215). Mean scores for QT versus ST were as follows: Kujala 91.4 ± 7.1 versus 88.4 ± 10.0 (p = 0.401), Lysholm 92.8 ± 7.5 versus 90.2 ± 10.4 (p = 0.464), IKDC 91.3 ± 6.1 versus 87.5 ± 12.1 (p = 0.725), Tegner 6.8 ± 1.2 versus 6.4 ± 1.5 (p = 0.516), and VAS 0.2 ± 0.5 versus 0.4 ± 1.0 (p = 0.935). The functional outcomes of reconstruction techniques using double bundle ST and partial QT autografts were both successful. Given the potential complications of ST technique, we believe partial QT could be a good alternative in MPFL reconstruction. LEVEL OF EVIDENCE: was retrospective cohort study, level 3.