Combined medial patellofemoral ligament and medial patellotibial ligament reconstruction in skeletally immature patients

Abstract

Patellar instability is a common knee disorder encountered in young athletes. Patients with normal osseous anatomy and mechanical alignment of the lower extremity are candidates for soft-tissue reconstructive procedures. In skeletally immature patients, surgical techniques that address patellar instability must avoid disruption of open physes and therefore must rely on soft-tissue techniques. Biomechanical research demonstrates that the medial patellofemoral ligament is the primary soft-tissue restraint to lateral subluxation of the patella, and the medial patellotibial ligament is an important secondary stabilizer. We present a novel physeal-sparing surgical technique that anatomically reconstructs both the medial patellofemoral and medial patellotibial ligaments using semitendinosus autograft.