Medial patellofemoral ligament reconstruction indications and surgical technique

Abstract

Patellar instability has been shown to be associated with four major factors. These factors are trochlear dysplasia, patellar height, lateral offset, medial retinacular restraint [22]. As other chapters will concern themselves with these first three factors, we will focus on the soft tissue medial retinacular restraint. It is the authors' view that medial retinacular restraint must be addressed to provide patellar stability, either in isolation or in conjunction with other procedures as indicated. Studies have demonstrated that soft tissue reconstructions are sufficient to reestablish patellar constraint. For instance systematic review of eight studies was performed to determine if medial patellofemoral ligament (MPFL) reconstruction is an appropriate procedure for patient with patellar instability [51]. Although the techniques, indications and follow-up outcome measures varied, of the 155 knees, only six had postoperative patellar dislocation or -subluxation episodes. © 2010 Springer-Verlag Berlin Heidelberg.