Ultrasound Combined With Arthroscopy-Assisted Localization and Reconstruction of the Medial Patellofemoral Ligament

Medial patellofemoral ligament reconstruction is an effective treatment for recurrent patellar dislocation. This technical note describes an ultrasound-assisted femoral localization strategy for medial patellofemoral ligament reconstruction, aiming to improve femoral tunnel accuracy, enhance isometry, and reduce soft-tissue dissection. Preoperatively, ultrasound is used to identify and mark the intersection of the horizontal line through the femoral footprint of the medial collateral ligament and the course of the adductor tendon as the target region; intraoperatively, localization and reconstruction are performed at a similar knee flexion angle, with patellofemoral alignment and tracking confirmed arthroscopically. Initial observations indicate high concordance between ultrasound marking and arthroscopic anatomic localization, enabling reliable femoral-side fixation with smaller incisions and potentially fewer complications, which may facilitate functional recovery. This strategy may shorten the learning curve and promote a more minimally invasive treatment pathway; however, its effectiveness depends on operator experience and equipment resolution and may be limited in cases of severe obesity.