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DOI: 10.1055/s-0037-1607192
Anatomic Double-Bundle Medial Patellofemoral Ligament Reconstruction with Autologous Semitendinosus: Aperture Fixation Both at the Femur and the Patella
Publication History
Publication Date:
04 October 2017 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00033766/201704/lookinside/thumbnails/10-1055-s-0037-1607192_1703332-1.jpg)
Abstract
Medial patellofemoral ligament (MPFL) represents the main restraint against lateral patellar displacement. The MPFL insertion at the patella is up to 30 mm wide and is located along the upper half of the medial patellar rim. The femoral insertion of the MPFL is approximately 10 mm distal to the apex of the adductor tubercle and 16 mm proximal to the medial epicondyle. Since most of the patients suffer from MPFL rupture just after the first patellar dislocation, MPFL reconstruction results necessarily in all cases of chronic objective patellar instability to reestablish the primary passive patellofemoral stabilizer. Over time, different techniques of MPFL reconstruction have been proposed with promising results in terms of patient satisfaction and redislocation rate. However, each of these techniques may present peculiar problems and/or complications. An anatomic double-bundle MPFL reconstruction through an aperture fixation both at the femur and at the patella is here presented. The anatomic double-bundle MPFL reconstruction could allow recreating the fan-shape and biomechanics of original MPFL, whereas aperture fixation could provide a strong and safe fixation without risk of loosening or slackening of the graft.
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References
- 1 Panni AS, Cerciello S, Vasso M. Patellofemoral instability: surgical treatment of soft tissues. Joints 2013; 1 (01) 34-39
- 2 Mochizuki T, Nimura A, Tateishi T, Yamaguchi K, Muneta T, Akita K. Anatomic study of the attachment of the medial patellofemoral ligament and its characteristic relationships to the vastus intermedius. Knee Surg Sports Traumatol Arthrosc 2013; 21 (02) 305-310
- 3 Wijdicks CA, Griffith CJ, LaPrade RF. , et al. Radiographic identification of the primary medial knee structures. J Bone Joint Surg Am 2009; 91 (03) 521-529
- 4 Panni AS, Vasso M, Cerciello S. Acute patellar dislocation. What to do?. Knee Surg Sports Traumatol Arthrosc 2013; 21 (02) 275-278
- 5 Hapa O, Akşahin E, Özden R. , et al. Aperture fixation instead of transverse tunnels at the patella for medial patellofemoral ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2012; 20 (02) 322-326
- 6 Schöttle PB, Hensler D, Imhoff AB. Anatomical double-bundle MPFL reconstruction with an aperture fixation. Knee Surg Sports Traumatol Arthrosc 2010; 18 (02) 147-151
- 7 Schöttle PB, Romero J, Schmeling A, Weiler A. Technical note: anatomical reconstruction of the medial patellofemoral ligament using a free gracilis autograft. Arch Orthop Trauma Surg 2008; 128 (05) 479-484
- 8 Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP. Anatomy and biomechanics of the medial patellofemoral ligament. Knee 2003; 10 (03) 215-220
- 9 Parker DA, Alexander JW, Conditt MA, Uzodinma ON, Bryan WJ. Comparison of isometric and anatomic reconstruction of the medial patellofemoral ligament: a cadaveric study. Orthopedics 2008; 31 (04) 339-343
- 10 Panni AS, Alam M, Cerciello S, Vasso M, Maffulli N. Medial patellofemoral ligament reconstruction with a divergent patellar transverse 2-tunnel technique. Am J Sports Med 2011; 39 (12) 2647-2655
- 11 Schiphouwer L, Rood A, Tigchelaar S, Koëter S. Complications of medial patellofemoral ligament reconstruction using two transverse patellar tunnels. Knee Surg Sports Traumatol Arthrosc 2017; 25 (01) 245-250
- 12 Zanon G, Marullo M, Benazzo F. Double-bundle medial patellofemoral ligament reconstruction with a single patellar tunnel. Arthrosc Tech 2013; 2 (04) e401-e404
- 13 Kang HJ, Cao JH, Pan S, Wang XJ, Yu DH, Zheng ZM. The horizontal Y-shaped graft with respective graft tension angles in anatomical two-bundle medial patellofemoral ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2014; 22 (10) 2445-2451