Hamstring Versus Quadriceps Tendon Graft for MPFL Reconstruction

Comparison Between Hamstring Versus Quadriceps Tendon Graft in MPFL Reconstruction for Recurrent Patellar Dislocation

This prospective comparative study compared the clinical and radiological outcomes of medial patellofemoral ligament (MPFL) reconstruction using a hamstring tendon graft versus a quadriceps tendon graft in patients with recurrent patellar dislocation. The study included 38 patients with 40 affected knees who underwent MPFL reconstruction using either a hamstring tendon graft or a quadriceps tendon graft, according to the treating surgeon's preference. Patients were prospectively followed in two groups according to the graft used. Clinical outcomes were assessed using the Kujala, International Knee Documentation Committee (IKDC), and Tegner-Lysholm scores. Radiological assessment included patellar tilt angle and congruence angle. Postoperative complications and recurrent patellar instability were also evaluated.

Study Overview

• Status: Completed
• Conditions: Recurrent Patellar Dislocation
• Intervention / Treatment: Procedure: MPFL Reconstruction Using Hamstring Tendon Graft; Procedure: MPFL Reconstruction Using Quadriceps Tendon Graft

• Study Type: Observational
• Enrollment (Actual): 38

Contacts and Locations

Study Locations

• Egypt
  • Cairo, Egypt
    • Cairo University Hospitals (Kasr Al-Ainy)

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients with recurrent patellar instability who underwent medial patellofemoral ligament reconstruction using either a hamstring tendon graft or a quadriceps tendon graft.

Description

Inclusion Criteria:

• Patients with recurrent patellar dislocation.
• Age from 18 to 40 years.
• Patients indicated for isolated medial patellofemoral ligament (MPFL) reconstruction.

Exclusion Criteria:

1. Patients with trochlear dysplasia (Dejour B-C-D).
2. Patients with clinical evidence of mal-alignment (varus, valgus, flat foot and femoral anteversion).
3. Patients with congenital pateller dislocation.
4. Patella alta and patella baja.
5. Previous quadriceps muscles operation.
6. Patients with patellofemoral OA.
7. Patients with hypermobility syndrome.
8. Patients with associated pathology.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Hamstring Tendon Graft Group; Patients who underwent MPFL reconstruction using a hamstring tendon graft.	Procedure: MPFL Reconstruction Using Hamstring Tendon Graft; Medial patellofemoral ligament reconstruction was performed using an autologous semitendinosus tendon graft. The graft was fixed to the medial aspect of the patella and passed between layers 2 and 3 of the medial knee structures, followed by femoral fixation at the anatomical MPFL insertion.
Quadriceps Tendon Graft Group; Patients who underwent MPFL reconstruction using a quadriceps tendon graft.	Procedure: MPFL Reconstruction Using Quadriceps Tendon Graft; Medial patellofemoral ligament reconstruction was performed using a distally based superficial quadriceps tendon graft. The graft remained attached to the superior pole of the patella, was passed between layers 2 and 3 of the medial knee structures, and was fixed at the anatomical femoral insertion of the MPFL.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Kujala score	Functional outcome assessed using the Kujala anterior knee pain scale. The score ranges from 0 to 100, with higher scores indicating better knee function and fewer patellofemoral symptoms.	12 months postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
International Knee Documentation Committee (IKDC) Score	Knee function was assessed using the International Knee Documentation Committee (IKDC) score. Scores range from 0 to 100, with higher scores indicating better knee function.	12 months postoperatively
Tegner-Lysholm Knee Score	Knee function was assessed using the Tegner-Lysholm knee score. Scores range from 0 to 100, with higher scores indicating better knee function.	12 months postoperatively
Patellar Tilt Angle	Patellar tilt angle was measured radiologically to assess patellofemoral alignment before and after MPFL reconstruction.	12 months postoperatively
Congruence Angle	Congruence angle was measured radiologically to assess patellofemoral alignment before and after MPFL reconstruction.	12 months postoperatively
Incidence of Re-dislocation	Number of cases who experienced re-dislocation after MPFL reconstruction	12 months postoperatively

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2018
• Primary Completion (Actual): June 1, 2022
• Study Completion (Actual): June 1, 2022

Study Registration Dates

• First Submitted: August 21, 2026
• First Submitted That Met QC Criteria: August 21, 2026
• First Posted (Actual): August 25, 2026

Study Record Updates

• Last Update Posted (Actual): August 25, 2026
• Last Update Submitted That Met QC Criteria: August 21, 2026
• Last Verified: August 1, 2026

More Information

Terms related to this study

• Keywords: Medial Patellofemoral Ligament; Patellar Instability; MPFL Reconstruction; Hamstring Tendon Graft; Quadriceps Tendon Graft
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Wounds and Injuries; Joint Diseases; Leg Injuries; Knee Injuries; Joint Dislocations; Patellar Dislocation
• Other Study ID Numbers: N-356-2018

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No