Comparative Outcomes of Return to Sports After Bilateral Versus Unilateral Medial Patellofemoral Ligament Reconstruction With FiberTape and Knotless SwiveLock Anchors in Young Athletes.

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 ± 1.9 years and 15.2 ± 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 ± 7.9 vs 89.2 ± 10.3; symptoms: 92.3 ± 8.7 vs 87.4 ± 11.9; activities of daily living: 88.9 ± 15.3 vs 94.2 ± 8.5; sports: 98.2 ± 3.2 vs 85.4 ± 15.5; quality of life: 91.6 ± 12.3 vs 81.4 ± 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 ± 2.6 and 5.3 ± 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.