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Single-tunnel and double-tunnel medial patellofemoral ligament reconstructions have similar clinical, radiological and functional results

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of the present study was to evaluate the clinical, radiological and functional results of patients underwent single-tunnel (ST) and double-tunnel (DT) medial patellofemoral ligament(MPFL) reconstructions with hamstring autograft following recurrent patella dislocation prospectively in a single institution.

Methods

From 2013 to 2017, 80 patients with symptomatic recurrent patellar dislocation or instability were randomly divided into 2 groups for MPFL reconstruction with ST technique or DT technique and evaluated prospectively. In the ST group, there were 20 male and 20 female with a median follow-up of 46.5 months (range 24–74). The median age was 15 years (range 10–28). In the DT group, there were 18 male and 22 female with a median follow-up of 40 months (range 24–74). The median age was 19 years (range 14–29). Clinical scores (Kujala score, Lysholm score, Tegner score and IKDC score) and radiological measurements (congruence angle and patellar tilt angle) of the patients were evaluated preoperatively and at postoperative 24th month. Isokinetic dynamometric tests were performed at postoperative 24th month and the difference between the operated leg and the non-operated leg was found as a percentage deficit.

Results

There were no postoperative complications, redislocation or subluxation in any patient. Kujala, Lysholm, Tegner and IKDC scores were better and statistically significant postoperatively in both groups (p < 0.05). However, there was no statistically significant difference between the groups (n.s.). The congruence angle and patellar tilt angle were found to be returned to normal values postoperatively, but there was no statistically significant difference between the groups (n.s.). There was no statistically significant difference between the two groups in isokinetic dynamometric tests performed as 60° flexion, 60° extension, 180° flexion and 180° extension (n.s.).

Conclusion

The present study is the first that compared the clinical, radiological and functional results of the ST and DT techniques to date. Regardless of the number of the tunnels, similar results were obtained in ST and DT reconstruction using transpatellar tunnel technique.

Level of evidence

Level I.

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Ankara Training and Research Hospital, Ankara, Turkey

    Niyazi Ercan

  2. Department of Orthopedics and Traumatology, Ankara University School of Medicine, Ankara, Turkey

    Ramazan Akmese

  3. Department of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey

    Burak Ulusoy

Authors
  1. Niyazi Ercan
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  2. Ramazan Akmese
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  3. Burak Ulusoy
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Correspondence to Niyazi Ercan.

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Institutional Review Board (IRB) approval was obtained from Ankara University School of Medicine Ethics Committee under the decision number (06-365-18).

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Ercan, N., Akmese, R. & Ulusoy, B. Single-tunnel and double-tunnel medial patellofemoral ligament reconstructions have similar clinical, radiological and functional results. Knee Surg Sports Traumatol Arthrosc 29, 1904–1912 (2021). https://doi.org/10.1007/s00167-020-06260-6

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