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. 2007 Feb 28:8:22.
doi: 10.1186/1471-2474-8-22.

Medial patellofemoral ligament reconstruction: a new technique

Michael R Carmont  1 , Nicola Maffulli
Affiliations

Medial patellofemoral ligament reconstruction: a new technique

Michael R Carmont et al. BMC Musculoskelet Disord. .

Abstract

Background: Primary patellofemoral dislocations are common. In most patients, non-operative management produces satisfactory outcome. If the dislocation recurs after a trial of rehabilitation, operative intervention is considered, with the aim of restoring the soft tissue anatomy to normal. Ninety four percent of patients suffer a tear to the medial patellofemoral ligament (MPFL) following a patellar dislocation.

Results: We describe our transverse patella double tunnel technique to reconstruct the medial patellofemoral ligament using a free autologous gracilis or semitendinous graft.

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Figures

Figure 1
Figure 1
Examination under anaesthesia revealing marked patella instability.
Figure 2
Figure 2
Following medial and lateral parapatellar incisions, the patella is stabilised using a large clamp on the right of the figure. Tunnels are produced by sequential drill holes in the superior half of the patella, 1 cm apart.
Figure 3
Figure 3
A Beath pin is used to pass a Vicryl loop through the patella tunnels.
Figure 4
Figure 4
The graft is passed through the tunnels, laterally then medially.
Figure 5
Figure 5
The medial epicondyle is exposed and the Beath pin is placed across the transepicondylar axis and a tunnel is drilled to accommodate and secure both ends of the graft. The graft is passed between the second and third layers of the knee.
Figure 6
Figure 6
The graft is pulled into the tunnel using Vicryl through the eye of the Beath pin.
Figure 7
Figure 7
After cycling the knee through a full range of movements to allow graft tension to settle, the graft is secured using an interference fit screw.
Figure 8
Figure 8
The improved stability of the patella is confirmed.
See this image and copyright information in PMC

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