Recurrent subluxation of the lateral meniscus is characterized by episodes of mechanical locking of the knee joint. To completely preclude the posterior segment of the lateral meniscus from undergoing anterior dislocation during deep knee flexion, the structures to which it is attached need to be relatively taut. The posterosuperior popliteomeniscal fascicle retains its tension during deep knee flexion; therefore, reconstruction of the posterosuperior and anteroinferior popliteomeniscal fascicles was performed with an autograft harvested from the iliotibial band. This technique provides stabilization of the posterior segment of the lateral meniscus during deep knee flexion without interfering with the normal movement of the lateral meniscus throughout the range of motion of the knee joint.
Reconstruction of the medial patellofemoral ligament (MPFL) for recurrent patellar dislocation provides significant improvements in knee function. However, various complications have been reported, with most attributed to incorrect positioning of anchoring sites for the reconstructed MPFL and inappropriate graft tension. Patellofemoral congruence at 30 of flexion on arthroscopy was therefore controlled using devices able to modify the length of the reconstructed MPFL. This was done under circumstances of external rotation of the knee joint and electrical stimulation of the quadriceps with the purpose of maintaining the patella in a lateral shift. Advantages of this technique include completely controllable correction on arthroscopy under the worst patellofemoral congruence induced by external rotation of the knee joint and electrical stimulation of the quadriceps at 30 of flexion of the knee joint; in other words, voluntary determination of lateral shift during arthroscopy.
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