Recently, medial patellofemoral ligament reconstruction has been emphasized for the treatment of patellar dislocation. This
study compared the results of medial patellofemoral ligament reconstruction by adductor magnus tenodesis with distal patellar
realignment in patients with recurrent patellar dislocation. Additionally, the development of patellofemoral osteoarthrosis
was compared for these two procedures at a median 10-year followup. Between 1994 and 2000, 47 consecutive patients were treated
for recurrent patellar dislocation by adductor magnus tenodesis (18 knees) or Roux-Goldthwait procedure (29 knees). Redislocations,
subjective symptoms, and functional outcomes were evaluated. Magnetic resonance imaging was performed at followup. The incidence
of patellar redislocation after surgery was 7% in the adductor magnus group and 14% in the Roux-Goldthwait group. Median Kujala
scores were 88 for the adductor magnus group and 86 for the Roux-Goldthwait group. Magnetic resonance imaging revealed patellofemoral
articular cartilage lesions in 22 knees (73.3%) at followup, including 14 (46.6%) with full-thickness cartilage loss. Radiographs
revealed patellofemoral osteoarthritis in five patients in the Roux-Goldthwait group and in none of the patients in the adductor
magnus group. Adductor magnus tenodesis is a reliable method to treat recurrent patellar dislocation. The medial patellofemoral
ligament reconstruction seems to reduce the risk of osteoarthrosis compared with distal realignment surgery.
Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations
were conducted in conformity with ethical principles of research, and that informed consent for participation in the study
was obtained.