Surgical technique report describes medial patellofemoral ligament reconstruction using autograft tendon in patellar instability, highlighting an anatomic solution for recurrent dislocation.
Summary: Recurrent lateral dislocation of the patella is usually treated with some combination of lateral release, proximal realignment or medial reefing, and distal realignment. Significant problems with redislocation and anterior knee pain after surgical intervention may be caused in part by poor-quality medial retinacular tissues and nonanatomic attempts to restrain the patella. Recent biomechanical studies have emphasized the functional importance of the medial patellofemoral ligament (MPFL) as the primary restraint to lateral translation of the patella. A technique for reconstruction of this ligament is described, by using local autograft tendon, which provides a sturdy check-rein to lateral translation. Our current indications for MPFL reconstruction are (a) recurrent lateral patella dislocations in patients with poor-quality medial soft tissues and no definable MPFL, and (b) failure of previous proximal or proximal and distal realignment procedures with continued medial laxity.
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Burks et al. (1997) studied this question.
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