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. 2021 Apr 26;10(5):e1345-e1350.
doi: 10.1016/j.eats.2021.01.037. eCollection 2021 May.

Medial Patellofemoral Ligament Reconstruction: Use of All-Suture Anchors for Patellar Fixation and a Dynamic Femoral Attachment

Jaime Dalla-Rosa  1 , José J Nogales  1 , Miguel Verdejo  2 , José I Nogales  3
Affiliations

Medial Patellofemoral Ligament Reconstruction: Use of All-Suture Anchors for Patellar Fixation and a Dynamic Femoral Attachment

Jaime Dalla-Rosa et al. Arthrosc Tech. .

Abstract

The medial patellofemoral ligament is one of the most relevant structures preventing patellar dislocation. Numerous surgical techniques have been described to reconstruct this structure and patellar biomechanics. Complications after this procedure concern both patella and femur. This technique avoids tunneling the patella and the use of intraoperative radiographs by using the adductor magnus tendon insertion.

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Figures

Fig 1
Fig 1
(A) Supine position, the right knee is flexed to 90°, a longitudinal incision one finger breadth medial to the anterior tibial tubercle is made, approximately 3 cm in length. (B) Harvesting of the gracilis tendon at the same fashion as in anterior cruciate ligament reconstruction. (C) Gracilis is prepared on the working table in a standard ligament reconstruction fashion.
Fig 2
Fig 2
Supine position, right knee, medial view. (A) Adductor magnus tendon is identified and dissected. (B) Guide suture is placed between 2-3 layers of the medial retinaculum, so it remains extra-articular (arrow).
Fig 3
Fig 3
Supine position, right knee, medial view. (A) Adductor magnus tendon is identified and dissected (arrow). (B) Guide suture is placed between 2-3 layers of the medial retinaculum, so it remains extra-articular.
Fig 4
Fig 4
Supine position, right knee, medial view. (A) Drilling of the medial all-suture anchor (white arrow). (B) Drilling of the superomedial all-suture anchor (dotted arrow). (C) Nonabsorbable sutures from both anchors. (D) Fixation of the graft using locking knots.
Fig 5
Fig 5
Supine position, right knee, medial view. (A) Graft is looped around A tendon and sutured itself (arrow). (B) View of patellar fixation. (C) Closure of retinaculum.
See this image and copyright information in PMC

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