Classification based Treatment Algorithm for Patellar sided Medial Patellofemoral Ligament Avulsion in Acute Primary Patellar Instability: A Retrospective Cohort Study | ||
| Benha Medical Journal | ||
| Volume 42, Issue 10, October 2025, Pages 124-133 PDF (862.23 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/bmfj.2025.408045.2580 | ||
| Authors | ||
| Iniya Prasanna Raajendiren1; Santosh K Sahanand* 2; David V Rajan2 | ||
| 1Ortho One Orthopaedic Speciality Centre, Coimbatore, India | ||
| 2Ortho One Orthopaedic Speciality Center, Coimbatore, India | ||
| Abstract | ||
| Aim: The purpose of this article is to re-define the medial patellofemoral ligament (MPFL) injury characteristics at its attachment to the patella and to evaluate the clinical outcomes of our treatment protocol in patients who presented acutely with first time traumatic patellar sided MPFL avulsion injuries. Methods: A retrospective analysis of 30 patients treated between 2020 and 2024 for acute primary lateral patellar instability with patellar-sided MPFL avulsion injuries was conducted. Patients were categorized into five types from P0 to P4 based on MRI findings and treatment protocol tailored accordingly. Kujala scores were assessed at baseline and at 3,6 and 12 months. Statistical analyses included repeated measures ANOVA and Bonferroni post-hoc testing. Results: The mean patient age was 18.2 years. 63.3% were female. P4 injuries were the most common (36.7%), followed by P0 (30%). Significant improvement in Kujala scores was observed across all time points (from 58.6 to 96.2 at 12 months) in all patients. Both conservative and surgical groups showed parallel functional recovery, with no recurrent instability reported. Conclusion: Patients with P1 to P4 injuries benefitted from acute surgical repair as evidenced by the absence of recurrent instability and higher Kujala scores. This individualized approach, incorporating injury pattern and associated pathology, improves patient selection for either conservative or type of surgical management and may serve as a foundation for standardized care in acute primary patellar dislocation. | ||
| Keywords | ||
| Primary patellar instability; Medial patellofemoral ligament avulsion; MPFL augmentation; surgical technique; MPFL outcomes | ||
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