Clinical and radiological outcomes after a quasi-anatomical reconstruction of medial patellofemoral ligament with gracilis tendon autograft

Abstract

Therapeutic case series, Level IV.

Medial patellofemoral ligament reconstruction with gracilis autograft for recurrent patellar instability: a case report

“…Failure of conservative measures and resultant recurrent patellar instability is a recognized indication for operative intervention to prevent further instability episodes, patellofemoral osteoarthritis, and associated loss of function. 1,8,18 Treatment of recurrent patellar instability with MPFL reconstruction is a hot topic in the orthopaedic literature, with more than 200 peer reviewed publications since 2014. Interest in anatomical insertions, restoration of optimal biomechanics, operative techniques, and associated clinical and radiographic outcomes dominates this research.…”

“…1,[20][21][22] Theoretically, this pressure results in the loss of knee motion and increases PF osteoarthritis (OA). 1,20 Conversely, in a biomechanical laboratory study using cadaver knees, a non-anatomical femoral attachment point in the adductor tubercle did not alter the pressures on the PF joint in comparison with an anatomical attachment. 21 Then again, controversy persists relative to defining the optimal attachment points for the MPFL graft.…”

“…[1][2][3][4] Consequently, it tears when the patella dislocates laterally. 1,5 The efficacy of MPFL reconstruction in the control of lateral patellar instability has already been demonstrated, and therefore, its reconstruction is currently one of the most widely used surgical approach. 1 Recurrent patellar instability is common, and multiple procedures have been described for its treatment.…”

“…1,5 The efficacy of MPFL reconstruction in the control of lateral patellar instability has already been demonstrated, and therefore, its reconstruction is currently one of the most widely used surgical approach. 1 Recurrent patellar instability is common, and multiple procedures have been described for its treatment. Medial patellofemoral ligament reconstruction can be successful in patients who have an incompetent medial patellofemoral ligament or who have failed medial patellofemoral ligament repair and present with recurrent patellar instability.…”

Combined reconstruction of the medial patellotibial and patellofemoral ligaments

“…Many of these are employed in patients with skeletal immaturity, high riding patella, trochlear dysplasia, and ligament hyperlaxity (14). They vary in terms of graft choice, type of fixation, patellar and femoral attachments and graft tension at the time of fixation (13,(15)(16)(17). A standard surgical technique to manage this condition remains elusive (15).…”