The Effects of Inaccurate Femoral Tunnel Placement During Medial Patellofemoral Ligament Reconstruction on Midterm Clinical Outcomes in Treatment of Recurrent Patellar Dislocation

BACKGROUND: There is a lack of evidence and continuous debate on whether femoral tunnel displacement substantially influences the clinical efficacy of medial patellofemoral ligament reconstruction (MPFL-R) in addressing recurrent patellar dislocation. PURPOSE: To investigate possible associations between inaccurate femoral tunnel placement during MPFL-R and clinical outcomes, with a specific focus on proximal tunnel malpositioning. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: ≤ 10 mm). Patient data were collected and pathoanatomic risk factors were evaluated. Clinical assessments included patient-reported outcome measures, including the International Knee Documentation Committee (IKDC), Kujala, Lysholm, and Tegner scores; subjective satisfaction; and postoperative complications. A subgroup analysis was performed between proximally malpositioned tunnels and tunnels lying in other directions. RESULTS: = .031) were statistically worse in the proximally located group, with insignificant improvements compared with preoperative levels. The suboptimal group showed a higher rate of overall complications, and anterior knee pain was more often reported in the proximally located subgroup. CONCLUSION: Inaccurate femoral tunnel positioning was associated with inferior midterm subjective functional scores and a higher rate of postoperative complications after MPFL-R. Proximal displacement in particular was associated with adverse clinical outcomes.