CC BY-NC-ND 4.0 · Joints 2017; 05(03): 188-190
DOI: 10.1055/s-0037-1606336
Technical Note
Georg Thieme Verlag KG Stuttgart · New York

Suture Anchors Fixation in MPFL Reconstruction using a Bioactive Synthetic Ligament

Massimo Berruto
1   SSD Chirurgia Articolare del Ginocchio, Istituto Ortopedico Gaetano Pini, Milan, Italy
,
Paolo Ferrua
1   SSD Chirurgia Articolare del Ginocchio, Istituto Ortopedico Gaetano Pini, Milan, Italy
,
Daniele Tradati
1   SSD Chirurgia Articolare del Ginocchio, Istituto Ortopedico Gaetano Pini, Milan, Italy
,
Francesco Uboldi
1   SSD Chirurgia Articolare del Ginocchio, Istituto Ortopedico Gaetano Pini, Milan, Italy
,
Eva Usellini
1   SSD Chirurgia Articolare del Ginocchio, Istituto Ortopedico Gaetano Pini, Milan, Italy
,
Bruno Michele Marelli
2   Dipartimento di Ortotraumatologia Generale e Chirurgie Ortopediche Specialistiche, Istituto Ortopedico Gaetano Pini, Milan, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
05 September 2017 (online)

Abstract

Medial patellofemoral ligament (MPFL) reconstruction has a key role in patellofemoral instability surgery. Many surgical techniques have been described so far using different types of grafts (autologous, heterologous, or synthetic) and fixation techniques. The hereby described technique for MPFL reconstruction relies on the use of a biosynthetic graft (LARS Arc Sur Tille, France). Fixation is obtained by means of suture anchors on the patellar side and a resorbable interference screw on the femoral side locating the insertion point according to Schottle et al. An early passive range of motion (ROM) recovery is fundamental to reduce the risk of postoperative stiffness; a partial weight bearing with crutches is allowed until 6 weeks after the surgery. In our experience, the use of a biosynthetic graft and suture anchors provides stable fixation, minimizing donor site morbidity and reducing the risk of patellar fracture associated with transosseous tunnels. This technique represents a reliable and reproducible alternative for MPFL reconstruction, thereby minimizing the risk of possible complications.

 
  • References

  • 1 Dejour H, Walch G, Nove-Josserand L, Guier C. Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 1994; 2 (01) 19-26
  • 2 Ellera Gomes JL. Medial patellofemoral ligament reconstruction for recurrent dislocation of the patella: a preliminary report. Arthroscopy 1992; 8 (03) 335-340
  • 3 Berruto M, Ferrua P, Uboldi F. , et al. Medial patellofemoral ligament reconstruction with bioactive synthetic ligament is an option. A 3-year follow-up study. Knee Surg Sports Traumatol Arthrosc 2014; 22 (10) 2419-2425
  • 4 Berruto M, Parente A, Ferrua P, Pasqualotto S, Uboldi F, Usellini E. Revision surgery in permanent patellar dislocation in DiGeorge Syndrome. Case Rep Orthop 2015; 2015
  • 5 Song SY, Kim IS, Chang HG, Shin JH, Kim HJ, Seo YJ. Anatomic medial patellofemoral ligament reconstruction using patellar suture anchor fixation for recurrent patellar instability. Knee Surg Sports Traumatol Arthrosc 2014; 22 (10) 2431-2437
  • 6 Schöttle PB, Schmeling A, Rosenstiel N, Weiler A. Radiographic landmarks for femoral tunnel placement in medial patellofemoral ligament reconstruction. Am J Sports Med 2007; 35 (05) 801-804
  • 7 Khemka A, Lord SJ, Doyle Z, Bosley B, Al Muderis M. Minimally invasive medial patellofemoral ligament reconstruction for patellar instability using an artificial ligament: a two year follow-up. Knee 2016; 23 (02) 261-266
  • 8 Legnani C, Ventura A, Terzaghi C, Borgo E, Albisetti W. Anterior cruciate ligament reconstruction with synthetic grafts. A review of literature. Int Orthop 2010; 34 (04) 465-471