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There is a paucity of published evidence assessing patients managed with combined acute patellofemoral stabilisation and osteochondral fixation. The purpose of this study is to report the outcomes of patients with osteochondral injuries secondary to acute traumatic patella dislocation treated with combined early fragment fixation and MPFL reconstruction using a quadriceps tendon turndown technique which has distinct advantages for this cohort, including preventing chondral overloading and non\u2010violation of the patella bone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent combined quadriceps tendon MPFL reconstruction and osteochondral fixation were included. Patient demographics, defect characteristics, complications and reoperations were evaluated. Patients were assessed with Lysholm, Kujala, KOOS\u2010PF scores and satisfaction scale at follow up. Pre\u2010operative MRI was assessed for presence of radiological risk factors for patella dislocation and post\u2010operative MRI was used to assess cartilage quality with MOCART 2.0 score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 19 patients (63.2% female) were included. The mean age was 17.4\u2009\u00b1\u20094.8 years and patients were followed up at a mean 15.8\u2009\u00b1\u20095.1\u00a0months post\u2010surgery. The mean defect size was 2.4\u00a0cm<jats:sup>2<\/jats:sup>\u2009\u00b1\u20091.3\u00a0cm<jats:sup>2<\/jats:sup>, with the most common defect location being the patella (13\/19; 68.4%) followed by the lateral femoral condyle (5\/19; 26.3%). At final follow up, the overall mean Lysholm, Kujala, and KOOS\u2010PF scores were 84.9\u2009\u00b1\u200911.1, 89.7\u2009\u00b1\u20095.8 and 80.6\u2009\u00b1\u200913.6, respectively. Seventeen patients (89.5%) were satisfied with their outcome. The mean MOCART 2.0 score at final follow\u2010up was 72.5. One patient required medial capsular plication with removal of a loose chondral body and microfracture and 3\u00a0knees required minor reoperations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combined acute osteochondral fragment fixation and MPFL reconstruction using a quadriceps tendon graft offers good radiological and patient\u2010reported outcomes with high satisfaction and low rates of recurrent patella dislocation. To our knowledge, this is currently the largest series of its kind in the literature and the results of this study provide a rationale for a combined approach using a quadriceps tendon graft for this cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-023-07430-y","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T06:03:40Z","timestamp":1683871420000},"page":"4007-4015","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Combined quadriceps medial patellofemoral ligament reconstruction and osteochondral fixation offers good patient\u2010reported outcomes and low rates of recurrent instability for osteochondral defects secondary to acute patella dislocation"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8835-0931","authenticated-orcid":false,"given":"John P.","family":"Scanlon","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Orthopaedic Research Foundation of Western Australia Perth Australia"},{"name":"<!--<label>2<\/label>--> Fiona Stanley Fremantle Hospitals Group Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antony C.","family":"Raymond","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Orthopaedic Research Foundation of Western Australia Perth Australia"},{"name":"<!--<label>3<\/label>--> University Hospitals Dorset NHS Foundation Trust Poole UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randeep S.","family":"Aujla","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Orthopaedic Research Foundation of Western Australia Perth 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The other authors report no actual or potential conflict of interest in relation to this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was acquired from every subject prior to study inclusion.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}