Medial capsule reefing in patellar instability.

Purpose: The efficacy of medial capsule reefing in the treatment of patellar instability is well documented. Aim of the present study was to prospectively evaluate the outcomes of an all-arthroscopic medial capsule reefing technique in young patients with painful patella syndrome and potential patellar instability.

Methods: Thirty patients with painful patellar syndrome and potential patellar instability having undergone a minimum of 6 months of intensive rehabilitation were enrolled in the present study. All subjects were evaluated with physical examination, clinical and functional outcomes and complete imaging study.

Results: All patients were reviewed at an intermediate follow-up of 72 months. Average Kujala score improved from 72.9±15.0 to 88.4±7.6 (p<0.0001), average Larsen score from 15.0±2.5 to 17.2±2.2 (p<0.002), average Lysholm from 63.8±16.7 to 87.9±11.7 (p<0.0001) and average Fulkerson score from 69.5±21.5 to 90.8±9.8 (p<0.0001). No intraoperative or postoperative complications were recorded. Ninety per cent of patients were very satisfied or satisfied with their functional result. Twenty-eight patients were reviewed at the final follow-up, 120 months after surgery. Average Kujala was 87.7±8.8 (p<0.0001), average Larsen was 16.8±2.7 (p<0.01), average Lysholm was 87.6±14.3 (p<0.0001), and average Fulkerson was 87.2±13.9 (p<0.0001). Almost 86% of patients were very satisfied or satisfied with their result. However, slight deterioration of the outcomes over time was observed.

Conclusion: At the final follow-up, the outcomes of all-arthroscopic technique were significantly improved from preoperative values; however, they were slightly inferior at the 72 months follow-up. This slight deterioration of the outcomes may be the consequence of the reduction in physical activities.

Level Of Evidence: Case series, Level IV.