Femoral tunnel enlargement after medial patellofemoral ligament reconstruction is common and can be monitored using plain radiographs

medial patellofemoral ligament reconstruction (MPFLr) is a common surgical procedure for treating patellar instability. Grafts can be fixed to the femur using a bone-tunnel technique with an interference screw. However, this may lead to femoral tunnel enlargement (FTE) post-operatively. The aim of t...

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Bibliographic Details
Published in:Journal of clinical orthopaedics and trauma 2025-01, Vol.60, Article 102835
Main Authors: Roberts, Tobias, Casey, Laura, Abelleyra Lastoria, Diego Agustín, Walters, Samuel, Smith, Toby, Hing, Caroline
Format: Article
Language:English
Subjects:
Femoral tunnel enlargement
Medial patellofemoral ligament reconstruction
MPFL
Patellofemoral instability
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Summary:medial patellofemoral ligament reconstruction (MPFLr) is a common surgical procedure for treating patellar instability. Grafts can be fixed to the femur using a bone-tunnel technique with an interference screw. However, this may lead to femoral tunnel enlargement (FTE) post-operatively. The aim of this study was to assess the correlation between time after MPFLr and FTE, to evaluate factors that might influence FTE and to determine if FTE can be reliably evaluated with plain radiographs. we conducted a single-surgeon series, retrospective review of 70 MPFLr (52 female; 18 male) between 2014 and 2022. We assessed change in femoral tunnel area compared with original tunnel area (TP0), on lateral radiographs at two time points. Time point one (TP1): mean 34 days (standard deviation (SD): 25); and Time Point 2 (TP2): mean 490 days (SD: 333). We analysed the relationship between surgical characteristics to FTE, and assessed inter- and intra-rater reliability of FTE. tunnel area significantly increased from TP0 to TP1 and TP2 (p 
ISSN:0976-5662
DOI:10.1016/j.jcot.2024.102835