Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2007

Open Access 01-12-2007 | Technical advance

Medial patellofemoral ligament reconstruction: a new technique

Authors: Michael R Carmont, Nicola Maffulli

Published in: BMC Musculoskeletal Disorders | Issue 1/2007

Login to get access

Abstract

Background

Primary patellofemoral dislocations are common. In most patients, non-operative management produces satisfactory outcome. If the dislocation recurs after a trial of rehabilitation, operative intervention is considered, with the aim of restoring the soft tissue anatomy to normal. Ninety four percent of patients suffer a tear to the medial patellofemoral ligament (MPFL) following a patellar dislocation.

Results

We describe our transverse patella double tunnel technique to reconstruct the medial patellofemoral ligament using a free autologous gracilis or semitendinous graft.
Appendix
Available only for authorised users
Literature
1.
Boden BP, Pearsall AW, Garrett WE, Feagin JA: Patellofemoral instability: evaluation and management. J Am Acad Orthop Surg. 1997, 5: 47-57.CrossRefPubMed
2.
Nikku R, Nietosvaara Y, Aalto K, Kallio PE: Operative treatment of primary patellar dislocation does not improve medium term outcome. Acta Orthop. 2005, 76 (5): 699-704. 10.1080/17453670510041790.CrossRefPubMed
3.
Buchner M, Baudendistel B, Sabo D, Schmitt H: Acute traumatic primary patellar dislocation: long term results comparing conservative and surgical treatment. Clin J Sport Med. 2005, 15 (2): 62-66. 10.1097/01.jsm.0000157315.10756.14.CrossRefPubMed
4.
Sallay PI, Poggi J, Speer KP, Garrett WE: Acute dislocation of the patella; a correlative pathoanatomic study. Am J Sports Med. 1996, 24 (1): 52-60.CrossRefPubMed
5.
Nomura E: Classification of lesions of the medial patellofemoral ligament in patellar dislocation. Int Orthop. 1999, 23 (5): 260-3. 10.1007/s002640050366.CrossRefPubMedPubMedCentral
6.
Ostemeier S, Stukenborg-Colsman C, Hurschler C, Wirth CJ: In vitro investigation of the effect of medial patellofemoral ligament reconstruction and medial tibial tuberosity transfer on lateral patella stability. Arthroscopy. 2006, 22 (3): 308-319.CrossRef
7.
Mologne TS, Friedman MJ: Arthroscopic anterior cruciateligament reconstruction with hamstring tendons: Indications, surgical technique and complications and their treatment. Surgery of the knee. Edited by: Scott WN. 2006, Philadelphia: Churchill Livingstone, 648-651. 4
8.
Maffulli N, Leadbetter WB: Free gracilis tendon graft in neglected tears of the Achilles tendon. Clin J Sport Med. 2005, 15 (2): 56-61. 10.1097/01.jsm.0000152714.05097.ef.CrossRefPubMed
9.
Warren LF, Marshall JL: The supporting structures and layers on the medial side of the knee. J Bone Joint Surg. 1979, 61-A (1): 56-62.
10.
Reider B, Marshall JL, Koslin B, Ring B, Girgis FG: The anterior aspect of the knee joint. J Bone Joint Surg. 1981, 63-A (3): 351-356.
11.
Conlan T, Garth WP, Lemons JE: Evaluation of the medial soft tissue restraints of the extensor mechanism of the knee. J Bone Joint Surg. 1993, 75-A (5): 682-693.
12.
Feller JA, Feagin JA, Garrett WE: The medial patellofemoral ligament revisited: an anatomical study. Knee Surg Sports Traumatol Arthrosc. 1993, 1: 184-186. 10.1007/BF01560202.CrossRefPubMed
13.
Desio SM, Burks RT, Bachus KN: Soft tissue restraints to the lateral patellar translation in the human knee. Am J Sports Med. 1998, 26 (1): 59-65.PubMed
14.
Mountney J, Senavongse W, Amis A, Thomas NP: Tensile strength of the medial patellofemoral ligament before and after repair or reconstruction. J Bone Joint Surg. 2005, 87-B: 36-40.
15.
Steensen RN, Dopirak RM, McDonald WG: The anatomy and isometry of the medial patellofemoral ligament. Implications for reconstruction. Am J Sports Med. 2004, 32 (6): 1509-1513. 10.1177/0363546503261505.CrossRefPubMed
16.
Sandmeier RH, Burks RT, Bachus KN, Billings A: The effect of reconstruction of the patellofemoral ligament on patella tracking. Am J Sports Med. 2000, 28 (3): 345-349.PubMed
17.
Ahmad CS, Shubin Stein BE, Matuz D, Henry JH: Immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation: a review of eight cases. Am J Sports Med. 2000, 28 (6): 804-810.PubMed
18.
Steensen RN, Dopirak RM, Maurus PB: Minimally invasive "crescenteric" imbrication of the medial patellofemoral ligament for chronic patellar subluxation. Arthroscopy. 2005, 21 (3): 371-375.CrossRefPubMed
19.
Muneta T, Sekiya I, Tsuchiya M, Shinomiya K: A technique for reconstruction of the medial patellofemoral ligament. CORR. 1999, 359: 151-155.CrossRef
20.
Schock EJ, Burks RT: Medial Patellofemoral ligament reconstruction using a hamstring graft. Op Tech Sports Med. 2001, 9 (3): 169-175.CrossRef
21.
Fernandez E, Sala D, Castejon M: Reconstruction of the medial patellofemoral ligament for patella instability using a semiteninosus autograft. Acta Orthop Belg. 2005, 71: 303-308.PubMed
22.
Drez D, Edwards TB, Williams CS: Results of medial patellofemoral ligament reconstruction in the treatment of patellar dislocation. Arthroscopy. 2001, 17 (3): 298-306.CrossRefPubMed
23.
Mikashima Y, Kimura M, Kobayashi Y, Miyawaki M, Tomatsu T: Clinical reults of isolated reconstruction of the medial patellofemoral ligament for recurrent dislocation and subluxation of the patella. Acta Orthop Belg. 2006, 72: 65-71.PubMed
24.
Nomura E, Inoue M: Hybrid medial patellofemoral ligament reconstruction using the semitendinous tendon for recurrent patellar dislocation: minimum 3 years follow up. Arthroscopy. 2006, 22 (7): 787-793.CrossRefPubMed
25.
Steensen RN, Dopirak RM, Maurus PB: A simple technique for reconstruction of the medial patellofemoral ligament using quadriceps tendon graft. Arthroscopy. 2005, 21 (3): 365-370.CrossRefPubMed
26.
Burks RT, Luker MG: Medial patellofemoral ligament reconstruction. Techniques in Orthopaedics. 1997, 12 (3): 185-191.CrossRef
27.
Farr J, Schepsis AA: Reconstruction of the medial patellofemoral ligament for recurrent patella instability. J Knee Surg. 2006, 19 (4): 307-316.CrossRefPubMed
28.
Ellera Gomes JL: Medial patellofemoral ligament reconstruction for recurrent dislocation of the patella: a preliminary report. Arthroscopy. 1992, 8 (3): 335-340.CrossRefPubMed
29.
Nomura E, Horiuchi Y, Kihara M: A mid-term follow-up of medial patellofemoral ligament reconstruction using an artificial ligament for recurrent patella dislocation. The Knee. 2000, 7: 211-215. 10.1016/S0968-0160(00)00072-7.CrossRefPubMed
30.
Smirk C, Morris H: The anatomy and reconstruction of the patellofemoral ligament. The Knee. 2003, 10: 221-227. 10.1016/S0968-0160(03)00038-3.CrossRefPubMed
31.
Bicos J, Carofino B, Andersen M, Schepsis AA, Fulkerson JP, Mazzocca A: Patellofemoral forces after medial patellofemoral ligament reconstruction. J Knee Surg. 2006, 19 (4): 317-326.CrossRefPubMed
32.
Ma CB, Francis K, Towers J, Irrgang J, Fu FH, Harner CH: Hamstring anterior cruciate reconstruction: a comparison of bioabsorbable interference screw and endobutton-post fixation. Arthroscopy. 2004, 20 (2): 122-128.CrossRefPubMed
33.
Elias JJ, Cosgarea AJ: Technical errors during medial patellofemoral ligament reconstruction could overload medial patellofemoral cartilage. Am J Sport Med. 2006, 34 (9): 1478-1485. 10.1177/0363546506287486.CrossRef
34.
Ellera Gomes JL, Marczyk LRS, de Cesar PC, Jungblut CF: Medial patellofemoral ligament reconstraction with semitendinous autograft for chronic patellar instability: a follow study. Arthroscopy. 2004, 20 (2): 147-151.CrossRefPubMed
Metadata
Title
Medial patellofemoral ligament reconstruction: a new technique
Authors
Michael R Carmont
Nicola Maffulli
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2007
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-8-22

Other articles of this Issue 1/2007

BMC Musculoskeletal Disorders 1/2007 Go to the issue

Research article

Lower back pain in physically demanding college academic programs: a questionnaire based study

Correspondence

Fracture prevention with vitamin D supplementation: considering the inconsistent results

Research article

Reliability and validity study of Persian modified version of MUSIC (musculoskeletal intervention center) – Norrtalje questionnaire

Research article

Reproducibility of goniometric measurement of the knee in the in-hospital phase following total knee arthroplasty

Research article

Lumbar position sense and the risk of low back injuries in college athletes: a prospective cohort study

Research article

Power grip, pinch grip, manual muscle testing or thenar atrophy – which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review