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Medial patellofemoral ligament reconstruction: a new technique.

Carmont MR, Maffulli N - BMC Musculoskelet Disord (2007)

Bottom Line: Primary patellofemoral dislocations are common.In most patients, non-operative management produces satisfactory outcome.We describe our transverse patella double tunnel technique to reconstruct the medial patellofemoral ligament using a free autologous gracilis or semitendinous graft.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Trauma and Orthopaedics, University Hospital of North Staffordshire, Keele University School of Medicine, Stoke on Trent, UK. mcarmont@hotmail.com <mcarmont@hotmail.com>

ABSTRACT

Background: Primary patellofemoral dislocations are common. In most patients, non-operative management produces satisfactory outcome. If the dislocation recurs after a trial of rehabilitation, operative intervention is considered, with the aim of restoring the soft tissue anatomy to normal. Ninety four percent of patients suffer a tear to the medial patellofemoral ligament (MPFL) following a patellar dislocation.

Results: We describe our transverse patella double tunnel technique to reconstruct the medial patellofemoral ligament using a free autologous gracilis or semitendinous graft.

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The graft is passed through the tunnels, laterally then medially.
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Figure 4: The graft is passed through the tunnels, laterally then medially.

Mentions: The patella is approached through a 4 cm midline incision. The prepatella fascia is elevated to allow the medial and lateral walls of the patella to be exposed through medial and lateral parapatellar incisions. The inferior portion of the patella is stabilised using large forceps. Using sequential tunnel enlargement with appropriately sized drills, two transverse tunnels are made in the upper third of the patella to accommodate a single thickness of the graft (Figure 2). The tunnels are drilled parallel to one another and 1 cm apart. Using a Beath pin, the graft is threaded through the two transverse tunnels from medial to lateral (Figure 3), and then from lateral to medial (Figure 4) so that the graft forms a loop through the patella. It is easier to advance the graft passing the thinner end first (normally, the portion of the tendon inserting on the pes anserinus) with local anaesthetic jelly (Instillagel, Farco Pharma, Cologne).


Medial patellofemoral ligament reconstruction: a new technique.

Carmont MR, Maffulli N - BMC Musculoskelet Disord (2007)

The graft is passed through the tunnels, laterally then medially.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1808455&req=5

Figure 4: The graft is passed through the tunnels, laterally then medially.
Mentions: The patella is approached through a 4 cm midline incision. The prepatella fascia is elevated to allow the medial and lateral walls of the patella to be exposed through medial and lateral parapatellar incisions. The inferior portion of the patella is stabilised using large forceps. Using sequential tunnel enlargement with appropriately sized drills, two transverse tunnels are made in the upper third of the patella to accommodate a single thickness of the graft (Figure 2). The tunnels are drilled parallel to one another and 1 cm apart. Using a Beath pin, the graft is threaded through the two transverse tunnels from medial to lateral (Figure 3), and then from lateral to medial (Figure 4) so that the graft forms a loop through the patella. It is easier to advance the graft passing the thinner end first (normally, the portion of the tendon inserting on the pes anserinus) with local anaesthetic jelly (Instillagel, Farco Pharma, Cologne).

Bottom Line: Primary patellofemoral dislocations are common.In most patients, non-operative management produces satisfactory outcome.We describe our transverse patella double tunnel technique to reconstruct the medial patellofemoral ligament using a free autologous gracilis or semitendinous graft.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Trauma and Orthopaedics, University Hospital of North Staffordshire, Keele University School of Medicine, Stoke on Trent, UK. mcarmont@hotmail.com <mcarmont@hotmail.com>

ABSTRACT

Background: Primary patellofemoral dislocations are common. In most patients, non-operative management produces satisfactory outcome. If the dislocation recurs after a trial of rehabilitation, operative intervention is considered, with the aim of restoring the soft tissue anatomy to normal. Ninety four percent of patients suffer a tear to the medial patellofemoral ligament (MPFL) following a patellar dislocation.

Results: We describe our transverse patella double tunnel technique to reconstruct the medial patellofemoral ligament using a free autologous gracilis or semitendinous graft.

Show MeSH
Related in: MedlinePlus