Purpose
To review the incidence of complications following primary medial patellofemoral ligament
(MPFL) reconstruction for recurrent patellar instability.
Methods
A literature search was conducted by querying PubMed and Scopus databases from database
inception through August 2022 according to the 2020 Preferred Reporting Items for
Systematic Review and Meta-analysis guidelines using the terms “Medial Patellofemoral
Ligament,” “MPFL,” “reconstruction,” “patellar,” and “instability.” Inclusion criteria
included studies reporting complications following primary MPFL reconstruction for
recurrent patellar instability. Exclusion criteria consisted of studies reporting
on patients undergoing concurrent osteotomy procedures, revision reconstruction, and
biomechanical or anatomic studies. The incidence of specific complications was aggregated
from the included studies.
Results
Twenty-eight studies, consisting of 1,478 patients (n = 1521 knees), with a mean age
of 23.3 years (mean range, 19-34.3 years) were identified. The overall incidence of
complications ranged from 0% to 32.3% of knees. Failure ranged from 0% to 10.7% of
knees, whereas patellar fractures occurred in 0% to 8.3% of knees, primarily in patients
treated with full-length transverse tunnel or 2-tunnel techniques. All patellar fractures
occurred in patients with patellar tunnels ranging from 4.5 to 6.0 mm in diameter.
The incidence of postoperative knee stiffness/range of motion deficit ranged from
0% to 20%. Persistent anterior knee pain, ranged from 0% to 32.3%.
Conclusions
Complications following primary MPFL reconstruction ranged from 0% to 32.3% of knees,
primarily consisting of residual anterior knee pain. Failure ranged from 0% to 10.7%
of knees, whereas patellar fractures were reported in 0% to 8.3% of knees. Fractures
primarily occurred with a full-length transverse tunnel or 2-tunnel techniques, whereas
all fractures occurred with patellar tunnels ranging from 4.5 mm to 6.0 mm in diameter.
Level of Evidence
IV; Systematic Review of Level I-IV studies.
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Article info
Publication history
Published online: February 08, 2023
Accepted:
January 27,
2023
Received:
December 29,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2023 by the Arthroscopy Association of North America
