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Published on: March 26, 2015
Anatomical two-bundle medial patellofemoral ligament reconstruction with hardware-free patellar graft fixation:
Stefan Hinterwimmer1, Andreas B Imhoff, Philipp Minzlaff
1Department for Orthopedic Sports Medicine, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Purpose:
Various techniques for reconstruction of the medial patellofemoral ligament (MPFL) have been developed. In this article, a modified technique for anatomical two-bundle MPFL reconstruction with hardware-free patellar graft fixation is described and the preliminary results of this technique are presented.
Methods:
A modified surgical technique for MPFL reconstruction with a gracilis tendon autograft and hardware-free patellar graft fixation using two short oblique bone tunnels is described in detail. Complications and preliminary results of this procedure were assessed in 19 patients at a mean follow-up of 16 ± 3 months using the Kujala score, Tegner scale, and Insall score.
Results:
No postoperative patellar dislocation or subluxation was reported. Eighty-nine per cent of the patients were either satisfied or very satisfied with the overall outcome. The mean Kujala score was 92 ± 7 (range 69-100), and the median Tegner scale was 5 (range 3-7). According to the Insall score, the results of 18 patients (95%) were rated as good or excellent. Postoperative complications occurred in 3 patients (16%), with two of them persisting only temporary.
Conclusions:
The described technique for anatomical two-bundle MPFL reconstruction is a safe and effective surgical procedure for the treatment of lateral patellar instability, with several methodical advantages compared to similar techniques. Further evaluation in a larger patient cohort with a longer follow-up is necessary to confirm these short-term results.
Level Of Evidence:
IV.