Comparative Outcomes of Return to Sports After Bilateral Versus Unilateral Medial Patellofemoral Ligament Reconstruction

Sep 29, 2026

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Medial patellofemoral ligament reconstruction (MPFLR) is used to treat recurrent lateral patellar instability, and this retrospective cohort study compares outcomes after simultaneous bilateral versus unilateral MPFLR using FiberTape with knotless SwiveLock anchors in young athletes. Forty-five knees met inclusion criteria with follow-up through 24 months. Postoperative KOOS scores were favorable in both groups without significant between-group differences, while return-to-sports (RTS) rates were similar in functional recovery overall. RTS timelines and likelihood of returning to sports did not differ significantly, supporting comparable recovery, knee function, and RTS potential.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Background

Hypothesis

Methods

Participants

Outcomes assessed

Results

Conclusion

Original Research Article Comparative Outcomes of Return to Sports After Bilateral Versus Unilateral Medial Patellofemoral Ligament Reconstruction With FiberTape and Knotless SwiveLock Anchors in Young Athletes Kyota Ishibashi,* y MD, PhD , Eiji Sasaki, y MD, PhD , Ryoto Kura, y MD, Yuka Kimura, y MD, PhD , Yukiko Sakamoto, y MD, PhD, and Yasuyuki Ishibashi, y MD, PhD Investigation performed at Hirosaki University, Hirosaki, Japan | Background: Medial patellofemoral ligament reconstruction (MPFLR) is widely used for treating recurrent lateral patellar instability, with advancements such as artificial tapes and anchor fixation aiming to improve biomechanical stability and recovery outcomes compared with traditional autograft techniques. However, limited research exists on the outcomes of simultaneous bilateral MPFLR.
Hypothesis: The time to return to sports (RTS) is longer for bilateral MPFLR than for unilateral MPFLR.
Study Design: Cohort study; Level of evidence, 3 .
Methods: Patients were divided into bilateral and unilateral MPFLR groups. RTS rates, time to RTS, and postoperative Knee injury and Osteoarthritis Outcome Score (KOOS) were assessed.
Results: A total of 45 knees were analyzed, including 21 in the unilateral group and 24 in the bilateral group. Their mean ages were 15.2 6 1.9 years and 15.2 6 2.1 years, respectively, with a minimum 2-year follow-up including evaluations at 1, 2, 3, 6, 12, and 24 months postoperatively. Both groups demonstrated favorable postoperative KOOS values across all subscales, with no significant differences between them (pain: 92.3 6 7.9 vs 89.2 6 10.3; symptoms: 92.3 6 8.7 vs 87.4 6 11.9; activities of daily living: 88.9 6 15.3 vs 94.2 6 8.5; sports: 98.2 6 3.2 vs 85.4 6 15.5; quality of life: 91.6 6 12.3 vs 81.4 6 16.9; all P . .05) . RTS rates were 92% for the bilateral group and 76% for the unilateral group, whereas the mean times to RTS were 6.1 6 2.6 and 5.3 6 2.4 months, respectively, showing no significant differences. Factors preventing RTS included knee pain, loss of interest, and lifestyle changes such as retirement to pursue higher education.
Conclusion: Bilateral MPFLR achieved comparable functional outcomes, recovery time, and RTS rates to unilateral procedures. This study suggests that bilateral MPFLR with FiberTape and knotless SwiveLock anchors is an effective treatment for young athletes, offering excellent postoperative knee function and a high RTS likelihood. Further prospective studies with larger cohorts are recommended to validate these results and assess long-term outcomes.
Keywords: patellar dislocation; medial patellofemoral ligament reconstruction; FiberTape; return to sports; SwiveLock | | | --- | --- | | Medial patellofemoral ligament reconstruction (MPFLR) is widely used to treat recurrent lateral patellar instability. 16,19,27 The MPFL is crucial for stabilizing the patella against lateral displacement, and its dysfunction
The Orthopaedic Journal of Sports Medicine, 14(1), 23259671251401597 DOI: 10.1177/23259671251401597
􀀂 The Author(s) 2026 | significantly impairs knee function, especially in active and athletic individuals.17 Traditional reconstruction techniques, often involving autografts and allografts, have shown favorable outcomes. Allograft tendons avoid donor site morbidity and reduce operative time. However, their use may be associated with a higher risk of graft laxity or failure due to slower biological incorporation compared with autografts. 1,15,29 | This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by-nc-nd/4.0/](licenses/by-nc-nd/4.0/)), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or bu

FAQs

What question does the study address about bilateral versus unilateral MPFLR?

The study compares postoperative functional outcomes and return-to-sports (RTS) between simultaneous bilateral MPFLR and unilateral MPFLR using FiberTape and knotless SwiveLock anchors.

What outcomes were measured after surgery?

RTS rates, time to RTS, and postoperative KOOS (Knee injury and Osteoarthritis Outcome Score) subscales were assessed across all follow-up time points.

What did the results show about KOOS scores and RTS timing?

Both groups showed favorable KOOS values across subscales with no significant differences. RTS rates and mean time to RTS were also not significantly different between bilateral and unilateral procedures.

Sep 29, 2026

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