Ouctome of Physis Sparing MPFL Reconstruction in Paediatric Patients in a Tertiary Care Centre

Abstract

Introduction: Recurrent patellar dislocation is a common cause of knee instability in the pediatric population, often resulting from injury or insufficiency of the medial patellofemoral ligament (MPFL). Surgical reconstruction of the MPFL has emerged as a reliable option to restore patellar stability, improve function, and prevent recurrence, especially in skeletally immature patients where traditional procedures may risk growth plate injury. Methods: The present study was a prospective comparative study conducted over 3 years at B.C. Roy Children Hospital. The study included 30 pediatric patients with recurrent patellar dislocation who underwent physis-sparing MPFL reconstruction and/or ACL reconstruction. Results: In this study of 30 pediatric patients undergoing medial patellofemoral ligament reconstruction, the mean age was 12.5 ± 2.1 years, with a slight male predominance (18 males, 12 females) and nearly equal distribution of affected knees (16 right, 14 left). The mean BMI was 19.8 ± 3.2 kg/m². Significant functional improvement was observed postoperatively, with the mean Kujala score increasing from 56.4 ± 8.7 to 89.3 ± 5.2 (p < 0.001) and the mean Lysholm score from 58.7 ± 7.9 to 91.1 ± 4.8 (p < 0.001). Recurrent patellar dislocation occurred in 2 patients (6.7%), and minor complications such as transient pain or swelling were noted in 4 patients (13.3%), with no major complications reported. Gender-wise comparison showed comparable functional outcomes between males and females, with no statistically significant differences in postoperative Kujala or Lysholm scores (p = 0.32 and 0.28, respectively). Conclusion: MPFL reconstruction in pediatric patients is safe and effective, improving knee stability and functional outcomes with low recurrence and minimal complications. Physeal-sparing ACL techniques, using the gracilis tendon and patellar suture anchor, preserve growth plates while providing stable fixation. Overall, these procedures reliably restore patellar and knee stability and improve quality of life in skeletally immature patients.