Background: Patellar instability results from bony, capsulo-ligamentary and/or muscular deformities. The most performed surgical techniques are anterior tibial tuberosity translocation and medial patellofemoral muscle reconstruction.

Objective: The aim of this study was to evaluate the clinical and functional results of these two surgical techniques.

Method: This retrospective study included 54 unstable patellas managed between January 1999 and November 2019 in several hospitals in Abidjan (Côte d'Ivoire). According to the Dejour classification, 13 lesions (24%) were classified as Type A, 30 (55%) as Type B, 9 (17%) as Type C, and 2 (4%) as Type D. Treatment consisted of ATT transfer and anatomical MPFL reconstruction guided by Dejour's classification. Clinical and functional results were assessed using the Müller score.

Results: Forty-three (79%) knees classified as Type A (n=13, 24%) and Type B (n=30, 55%) were operated on by ATT translocation (Group A). Eleven (20%) knees classified as Type C (n=9, 17%) and D (n=2, 4%) were operated on by anatomical MPFL reconstruction (Group B). In Group A, 11 (25%) had a very good result, 29 (67%) had a good result, 1 (2%) had an average result, and 2 (4%) had a poor result. In Group B, 2 (18%) had a very good result, 7 (63%) had a good result, 1 (9%) had an average result, and 1 (9%) had a poor result. Six (13%) complications were found in the 43 patients in Group A. In Group B patients, 4 (36%) complications were identified.