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DOI: 10.1055/s-2007-965360
© Georg Thieme Verlag KG Stuttgart · New York
MPFL Reconstruction for Recurrent Patella Dislocation: A New Surgical Technique and Review of the Literature
Publication History
accepted after revision April 19, 2007
Publication Date:
18 September 2007 (online)
![](https://www.thieme-connect.de/media/sportsmed/200805/lookinside/thumbnails/10.1055-s-2007-965360-1.jpg)
Abstract
Recurrent dislocation, subluxation and functional instability due to patellofemoral pain might be present in 30 % to 60 % of patients managed non-operatively for posttraumatic patella instability. Disruption of the capsule, medial patella retinaculum and/or vastus medialis obliquus have been associated with recurrent patella instability but recently the medial patellofemoral ligament (MPFL) has been recognised as the most important ligamentous stabiliser preventing lateral dislocation of the patella. Many nonanatomical surgical techniques for the treatment of recurrent patellar dislocation have been described in the literature. These procedures alter the pre-morbid patella mechanics by several principles, including the release of tight lateral ligaments, tensioning of loose medial structures and distal realignment of the extensor mechanism or a combination of these. Very few address the principle site of pathology in patella dislocation, i.e., the torn MPFL. The outcomes are inconsistent and many studies have reported recurrent dislocations and patellofemoral pain and arthritis in up to 40 %. We describe a simple technique of MPFL reconstruction using a single hamstring tendon graft which is passed through the medial intermuscular septum at the adductor's magnus insertion and is fixed to the superomedial pole of the patella. A comprehensive review of the existing techniques of MPFL reconstruction using semitendinosus tendon autografts is also provided.
Key words
traumatic patella dislocation - patella instability - MPFL reconstruction
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Dr. MD, PhD, Senior Clinical Fellow Andreas Panagopoulos
Centre for Sports Injury Surgery, Friarage and Duchess of Kent Military Hospitals
Orthopaedics and Trauma
North Yorkshire, UK
DL6 1JG Northallerton
United Kingdom
or
25 Martiou 1
26504 Kato Kastritsi
Patras, Greece
Phone: + 30 69 44 36 36 24
Fax: + 30 26 10 46 40 33
Email: andpan21@gmail.com