Medial Patellofemoral Ligament Reconstruction With Transverse Reefing (Tubing) of Medial Patellar Retinaculum and Biological Fixation

The medial patellofemoral ligament (MPFL) is regarded as one of the main stabilizers of the knee. Its importance is underscored by the fact that in most cases of acute lateral patellar dislocation, rupture of the MPFL occurs. It is also a key factor in recurrent patellar dislocations. Therefore, MPFL reconstruction surgery is the current approach to managing such cases. Numerous techniques have been practiced by surgeons, with some being more prevalent than others. Although there is extensive literature comparing the efficacy and safety of different techniques, no clear consensus has been reached. Furthermore, recurrent postoperative complications, such as knee pain, have prompted surgeons to seek new and less invasive techniques. In this technical note, we describe an implant‐free MPFL reconstruction method leveraging the medial patellar retinaculum. Through horizontal suturing, a reinforced tubular reef is created to mimic the native MPFL and is secured via a subperiosteal femoral pouch with minimal invasiveness. This approach avoids bone tunnels, and it is expected to reduce fracture risk, eliminate donor‐site morbidity, and enhance reproducibility for surgeons.