Vol. 5, Issue 1, Part A (2023)

Background: In young, active patients, a patellar dislocation is a frequent knee injury. Long-term non operative treatment is reportedly becoming less popular in recent years, and patients who fail initial non operative management for recurring patellar dislocations are more frequently advised to undergo surgery. More frequently used in this context is medial patellofemoral ligament (MPFL) repair.
The Medial Patellofemoral Ligament, which is usually damaged by an acute lateral patellar dislocation, serves as the main barrier against excessive lateral displacement. Patients who experience frequent episodes of lateral patellar instability and fail a thorough non operative therapy are candidates for surgery. 
Objectives: The objectives of this study was to evaluate the clinical, functional, and radiological results of isolated MPFL reconstruction for recurrent lateral patellar dislocation.
Methods: In the Department of Orthopaedics at Bangabandhu Sheikh Mujib Medical University, a prospective study was carried out between January 2020 and December 2021 with a 1-year follow-up. The study comprised 34 individuals with repeated unilateral patellar dislocation and persistent patellar instability without any anatomical predisposing factors. The modified Cincinnati and Kujala scores and anthropometry were used in the evaluation.
Results: Prior to surgery, the mean modified Cincinnati score was 50; after surgery, it was 85 (P =.001). Preoperatively, the mean Kujala scores were 43; postoperatively, they were 80 (P =.03). With time, the muscle volume of the operated limb's thigh rise, but it didn't develop as well as the unoperated limb (P =.04). Preoperatively, the mean Insall-Salvati index was 1.1 (range, 0.9-1.2), and at the most recent follow-up, it was still within the normal range (1.1 [range, 0.9 to 1.2]) (P =.07). The anthropometric measurement of muscle volume of the thigh of the operated limb increased with time (2.95±0.50 L preoperatively to3.75±0.7 L at follow-up; P = .03). 
Conclusion: The safe, effective treatment option for recurrent patellar dislocation in individuals without any predisposed anatomic features is medial patellofemoral ligament restoration utilizing hamstring tendon.