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Bones of the Lower Limb: Femur and Patella01:16

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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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Medial Patellofemoral Reconstruction With a Hamstring Allograft.

Hailey P Huddleston1, Navya Dandu1, Blake M Bodendorfer1

  • 1Rush University Medical Center, Chicago, Illinois, USA.

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|May 1, 2025
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Summary

Medial patellofemoral ligament (MPFL) reconstruction effectively treats recurrent lateral patellar instability in active patients. This surgical procedure demonstrates high success rates, offering a solution for those who do not respond to conservative management.

Keywords:
MPFCMPFLmedial patellofemoral complexmedial patellofemoral ligament reconstructionpatellar instabilitysurgical technique

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanical Engineering

Background:

  • Lateral patellar instability is a prevalent condition among young, active individuals.
  • Medial patellofemoral ligament (MPFL) reconstruction is a viable surgical option for patients unresponsive to conservative treatments.

Purpose of the Study:

  • To detail the surgical technique for MPFL reconstruction.
  • To evaluate the efficacy and outcomes of MPFL reconstruction for lateral patellar instability.

Main Methods:

  • Surgical technique involves diagnostic arthroscopy, graft preparation (semitendinosus allograft), and fixation using suture anchors at the patella and a femoral tunnel.
  • Key steps include identifying the Schöttle point, preparing a patellar trough, tunneling the graft, and securing it with an interference screw in the femoral tunnel.
  • Assessment of isometry and patellar translation is crucial during the procedure.

Main Results:

  • MPFL reconstruction achieves high success rates in the majority of patients.
  • Reported complications include low rates of instability (1.2%), apprehension (3.6%), and reoperation (3.1%).
  • Potential complications encompass patellar fracture, patellofemoral pain, and reduced range of motion.

Conclusions:

  • MPFL reconstruction is a generally successful procedure for managing lateral patellar instability.
  • The technique offers a reliable solution for patients with persistent instability, with a low incidence of adverse outcomes.