Comparative analysis of MPFL reconstruction in recurrent dislocation of patella using peroneus longus graft versus semitendinosus: a retrospective study

Ramkoushik Parthasarathi; Nageswara Rao Vutharkar; Shaik Shafi Iliyas; Kanagarla Siva Praful; Jeevan Valluru

doi:10.18203/issn.2455-4510.IntJResOrthop20263911

Authors

Ramkoushik Parthasarathi Department of Orthopaedics, GSL Medical College and General Hospital, Rajahmundry, Andhra Pradesh, India
Nageswara Rao Vutharkar Department of Orthopaedics, GSL Medical College and General Hospital, Rajahmundry, Andhra Pradesh, India
Shaik Shafi Iliyas Department of Orthopaedics, GSL Medical College and General Hospital, Rajahmundry, Andhra Pradesh, India
Kanagarla Siva Praful Department of Orthopaedics, GSL Medical College and General Hospital, Rajahmundry, Andhra Pradesh, India
Jeevan Valluru Department of Orthopaedics, GSL Medical College and General Hospital, Rajahmundry, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20263911

Keywords:

Kujala and Lysholm score, Medial patellofemoral ligament, Peroneus longus tendon, Semitendinosus tendon

Abstract

Background: Recurrent patellar dislocation is most commonly associated with injury to the medial patellofemoral ligament (MPFL). MPFL reconstruction is the standard treatment. While semitendinosus tendon is traditionally used, peroneus longus tendon has emerged as an alternative graft with potentially less donor-site morbidity. This study aimed to compare functional outcomes, patient satisfaction, complications, and failure rates following MPFL reconstruction using peroneus longus versus semitendinosus tendon.

Methods: A retrospective comparative study was conducted on 30 patients with recurrent patellar dislocation. Group A (n=15) underwent MPFL reconstruction using semitendinosus graft, and Group B (n=15) using peroneus longus graft. Patients were followed for a minimum of 12 months. Outcomes were assessed using Kujala and Lysholm knee scores, range of motion, patient satisfaction rate, donor-site morbidity, and failure rate. Statistical analysis was performed using SPSS.

Results: Both groups showed significant improvement in functional scores (p<0.001). Group B demonstrated significantly higher postoperative Kujala and Lysholm scores, better patient satisfaction, lower donor-site morbidity, and lower failure rate.

Conclusions: Peroneus longus tendon is a safe, reliable, and effective alternative graft for MPFL reconstruction with superior functional outcomes and patient satisfaction compared to semitendinosus tendon.

References

Nomura E, Horiuchi Y, Inoue M. Correlation of MR imaging findings and open exploration of medial patellofemoral ligament injuries in acute patellar dislocations. Knee. 2002;9(2):139-43.

Dejour D, Saggin P. The sulcus deepening trochleoplasty-the Lyon’s procedure. Int Orthop. 2010;34(2):311-6.

Ellera Gomes JL. Medial patellofemoral ligament reconstruction for recurrent dislocation of the patella: a preliminary report. Arthrosc. 1992;8(3):335-40.

Mountney J, Senavongse W, Amis AA, Thomas NP. Tensile strength of the medial patellofemoral ligament before and after repair or reconstruction. J Bone Joint Surg Br. 2005;87(1):36-40.

Han M, Zhang Q, Chen W, Zhang S, Zhang W, Mou L, et al. Reconstruction of the medial patellofemoral ligament with autologous peroneal longus tendon versus semitendinosus tendon. Int Orthop. 2022;46:1341-9.

Migliorini F, Trivellas A, Driessen A, Quack V, Tingart M, Eschweiler J, et al. Graft choice for isolated MPFL reconstruction: gracilis versus semitendinosus. Eur J Orthop Surg Traumatol. 2020;30(5):763-70.

Kyung HS, Kim HJ. Medial patellofemoral ligament reconstruction: a comprehensive review. Knee Surg Relat Res. 2015;27(3):133-40.

Wylie JD, Burks RT. Medial patellofemoral ligament reconstruction with semitendinosus autograft. Arthrosc Tech. 2013;2(4):e417-21.

Camanho GL, de Christo Viegas A, Bitar AC, Demange MK, Hernandez AJ. Conservative versus surgical treatment for repair of the medial patellofemoral ligament in acute dislocations of the patella. Arthrosc. 2009;25(6):620-5.

LaPrade MD, Kallenbach SL, Aman ZS, Moatshe G, Storaci HW, Turnbull TL, et al. Biomechanical evaluation of the medial stabilizers of the patella. Am J Sports Med. 2018;46(7):1575-1582.

Wang Q, Huang W, Cai D, Huang H. Biomechanical comparison of single- and double-bundle medialpatellofemoral ligament reconstruction. J Orthop Surg Res. 2017;12(1):29.