Simultaneous Reconstruction of Medial Patellofemoral and Medial Patellotibial Ligaments

Medial patellofemoral ligament (MPFL) reconstruction (MPFLR) is the gold standard for treatment of recurrent patellofemoral dislocation; the medial patellotibial ligament (MPTL) may be added in certain patients.

Habitual patellar dislocation in flexion; recurrent patellar dislocation associated with knee hyperextension; mild patella alta; low-grade trochlear dysplasia; patients with open physis who have contraindication for bony procedures; apprehension in deep flexion; and recurrent patellar dislocators without obvious risk factors but marked apprehension.

MPFLR and MPTLR using a single peroneal tendon allograft. The patellar fixation includes a tunnel and one anchor, the tibia one anchor, while the femur does not use implants but a sling around the adductor magnus tendon.

This is a safe procedure with a preliminary low rate of complications and good functional results.

We recommend MPFLR plus MPTLR with a single graft to add extra stability. It is a surgical technique that can be used in both children and adults, but is particularly useful in patients with open physes.

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