Medial Patellofemoral Reconstruction With a Hamstring Allograft

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.