Synthetic suture tape for medial patellofemoral ligament reconstruction is an effective treatment for complex paediatric patellofemoral instability

Abstract

AbstractPurposeTo assess the outcomes of medial patellofemoral ligament (MPFL) reconstruction using synthetic suture tape in paediatric patients with patellofemoral instability (PFI).MethodsThis ambispective comparative study, conducted from 2014 to 2022, included paediatric patients who underwent MPFL reconstruction with synthetic suture tape and had a minimum follow‐up of 1 year. Pre‐ and postoperative clinical and functional outcomes, patient satisfaction and complications were assessed.ResultsThe study comprised 22 patients (29 knees), with a median age at surgery of 14.4 years (interquartile range [IQR] 10.9–16.7) and a median follow‐up of 46.5 months (24.7–66). Notably, 13 knees (44.8%) had open growth plates at the time of surgery. The cohort included patients with Down syndrome (3 patients), Ehlers‐Danlos (2), arthrogryposis (1), generalized joint hypermobility (8) and previous unsuccessful PFI surgeries (8). Concomitant procedures were performed on 16 knees. Postoperatively, improvements were observed in all but one patient, who reported residual pain. There were two other complications: one suture‐tape rupture and one surgical wound infection. Functional scores significantly improved: Kujala, +14 points (7–29) (p < 0.001); IKDC, +10.5 points (5.2–25.3) (p < 0.001); Tegner, +2 points (0–4) (p < 0.001); Lysholm, +15 points (0–37.5) (p < 0.001). Most patients achieved excellent outcomes by Crosby‐Insall criteria (21 patients, 72.4%) and reported high satisfaction (23 patients, 79.3%).ConclusionsMPFL reconstruction using synthetic suture tape is a viable and effective treatment for paediatric patients with PFI, particularly for those with connective tissue disorders, generalized joint hypermobility or past surgical failures, significantly enhancing clinical and functional outcomes with an acceptable complication rate.Level of EvidenceLevel IV.