Medial Patellofemoral Complex and Medial Quadriceps Tendon-Femoral Ligament Reconstruction

Management of patellofemoral instability has evolved over time with improved understanding of patellofemoral anatomy and kinematics. Specifically, increased understanding of the main medial soft-tissue stabilizer of the patellofemoral joint, the medial patellofemoral complex, is now understood to comprise the medial patellofemoral ligament and medial quadriceps tendon-femoral ligament. Reconstruction of either ligamentous attachment can be performed to restore the soft tissue restraint, as long as the principles of anatomic reconstruction, avoiding overtightening, and addressing concurrent morphologic risk factors are maintained. We review the relevant anatomy, biomechanics, and surgical principles of medial quadriceps tendon-femoral ligament reconstruction to recreate the medial patellofemoral complex in the setting of patellar instability.