Restoration of native medial patellofemoral ligament support after patella dislocation

Abstract

Much as the anterior talofibular ligament can be advanced to stabilize the lateral ankle, the healed, elongated medial patellofemoral ligament (MPFL) can be advanced to restore patellofemoral stability. We describe a simple technique whereby the MPFL remnant and femoral insertion can be easily identified and tested for integrity through a mini-open technique. In 13 consecutive cases after patellar dislocation, the MPFL was identified as a healed but elongated structure, with an intact, anatomically correct femoral insertion. Advancement of this healed, but elongated structure effectively restores stability in most patients. This helps in understanding why vastus medialis obliquus advancement has successfully restored patella stability in many patients after recurrent dislocation. MPFL advancement is an important alternative to full MPFL reconstruction in some patients.