Short‐term benefits of hybrid graft in medial patellofemoral ligament reconstruction for recurrent patellar dislocation: A prospective randomised controlled trial with minimum 2‐year follow‐up
Knee Surgery Sports Traumatology Arthroscopy · 26 Oct 2026
† Impact is the editorial-priority score. All scores are out of 100. Clinical is a stored clinical-importance score from the earlier method; it has not been recalculated.
Why it matters
Graft choice in MPFL reconstruction is a common patellofemoral instability question, and this trial suggests synthetic augmentation may speed early recovery without changing 1-year function, while long-term safety of synthetic material remains unknown.
The evidence
This single-centre randomised trial compared MPFL reconstruction using a semitendinosus autograft alone versus a hybrid graft (semitendinosus braided with a 6-mm LARS synthetic tape) in 46 analysed young adults with recurrent patellar dislocation and no major bony risk factors. The hybrid group scored higher on Kujala and IKDC at 3 months (Kujala 82.4 vs 68.6) and 6 months (88.4 vs 83.4). The prespecified primary outcome, Kujala at 12 months, did not differ (93.2 vs 91.8, p = 0.185), and neither did scores at final follow-up of about 2 years or CT patellar alignment.
A coherent primary effect estimate is unavailable. Clinical relevance does not estimate treatment benefit.
Why this rigour score?
RCTDesign starting point: 59.5
Raised the score
- Blinded outcome assessment+6.8
- Adequately powered+6
Lowered the score
- 21% loss to follow-up−4.3
Score capped at 55. The conclusion asserts a benefit the primary outcome did not show.
Methods at a glance
Recorded assessment- Outcome assessors blindedMet
- Allocation concealedMet
- Random sequence generatedMet
- Intention-to-treat analysisNot reported
- Adequate statistical powerMet
- Prospective registrationMet
Not reported does not mean not done. Checks have different weights; this is not a count of boxes ticked.
See the full score breakdown
- Study design starting point
- 59.5
- Concealed allocation
- +5.1
- Random sequence generation
- +2.5
- Compared against current standard of care
- +3.4
- Blinded outcome assessment
- +6.8
- 21% loss to follow-up
- −4.3
- Adequately powered
- +6
- Prospectively registered
- +5.1
- Methodological cap
- −29.1
- Final rigour score rounded
- 55 / 100
Study design sets the starting point and a ceiling of 96. Recorded methods then adjust the score. Points are shown to one decimal place; the final score uses unrounded values.
Checklist from the stored appraisal. “Not met” describes the recorded criterion; it does not always produce a deduction. This overview supports reading the full study.
For journal club
1.Would a faster early recovery at 3 to 6 months justify the added device cost and the unknown long-term risks of a synthetic ligament for a young patient with recurrent patellar dislocation, and which patients (for example, in-season athletes) might value it most?
2.Since patients with high TT-TG, trochlear dysplasia, patella alta, or rotational deformity were excluded, how would you counsel a patient with these risk factors about isolated MPFL reconstruction with or without synthetic augmentation?
Original publication title
Short‐term benefits of hybrid graft in medial patellofemoral ligament reconstruction for recurrent patellar dislocation: A prospective randomized controlled trial with minimum 2‐year follow‐up