Purpose
This study aimed to compare the clinical, functional, and imaging outcomes of single-tunnel
(ST) and double-tunnel (DT) techniques for medial patellofemoral ligament (MPFL) reconstruction.
Methods
Ninety-four patients with recurrent patellar instability were randomly divided into
2 groups, receiving either ST or DT MPFL reconstruction. Lateral reticulum release
(LRR) and tibial tuberosity (TT) transfer were performed as combined procedures when
necessary. Preoperative and postoperative clinical characteristics (symptoms and episodes
of redislocation), functional outcomes (Kujala, Lysholm, Tegner, IKDC, and KOOS score),
and radiological measurements (congruence angle, patellar tilt angle, lateral patellar
angle, and lateral patellar translation) were analyzed.
Results
The analysis included data from 90 patients with 48 patients in the ST group and 42
patients in the DT group. Patients were followed up for a mean period of 37.8 (range:
27-50) months in the ST group and 38.6 (range: 25-53) months in the DT group. Forty-three
patients in the ST group and 40 patients in the DT group received combined TT transfer,
and all patients underwent LRR. At the latest follow-up, 1 patient in ST group experienced
redislocation, while no patient in the DT group sustained clinical failure (P = .347). Imaging measurements decreased significantly to the normal range postoperatively.
No significant difference was noted between the postoperative radiological results
of the 2 groups. All clinical scores significantly improved postoperatively, and no
significant difference was observed between the 2 groups except for the higher Lysholm
score (P = .031), KOOS symptoms score (P = .021) and KOOS knee-related quality of life score (P = .043) in the DT group.
Conclusion
Both techniques could equally mitigate the patellar lateral translation or redislocation.
Our results demonstrate several significant differences in functional outcomes that
favored DT MPFL reconstruction but no difference in clinical failure rates and radiological
results between ST and DT MPFL reconstruction.
Level of Evidence
Level I, randomized clinical trial.
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Article Info
Publication History
Published online: June 08, 2022
Accepted:
April 26,
2022
Received:
December 17,
2021
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report the following potential conflicts of interest or sources of funding: The study was funded by the Exploratory Research Program of Shanghai Jiao Tong University Affiliated Sixth People’s Hospital (grant YNTS202001 ) and the Shanghai Pujiang Program (grant 2020PJD041 ).Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
