Medial patellofemoral ligament reconstruction using superficial layer of quadriceps tendon autograft: A case series of three patients

Introduction: Recurrent patellar dislocation which caused by Medial Patellofemoral Ligament (MPFL) injury could be treated by MPFL reconstruction. This study evaluated MPFL reconstruction using superficial layer of quadriceps tendon autograft with knee functional outcome. Method: Three patients with recurrent patellar dislocation underwent MPFL reconstruction with superficial layer of quadriceps tendon autograft. The central quadriceps tendon was harvested at the superficial layer of the tendon. Then the proximal autograft routed medially on the periosteal hinge through vastus medial muscle. Functional outcome using IKDC, Tegner-Lysholm, and Modified Cincinnati were assessed pre and post-operative. Result: A good stability and painless knees were achieved. IKDC score, Tegner-Lysholm, and Modified Cincinnati was improved from pre-operative to post-operative. No severe postoperative complication was recorded. Discussion: The superficial layer of quadriceps tendon has similar biomechanical and anatomical macroscopic attribute to native MPFL. The procedure using quadriceps tendon was simple and has fewer complication than using other autografts, such as hamstring tendon, adductor tendon, and patellar tendon. The one-year follow-up outcome of this procedure is excellent. Conclusion: MPFL reconstruction with superficial layer of quadriceps tendon autograft was proven to prevent patellar dislocation without deteriorating quadriceps muscle strength and produced knee stabilization with functional score improvement.