Medial Patellofemoral Ligament Isometry in the setting of Patella Alta

Abstract

Objectives:Patella alta increases the complexity of decision making in regards to surgical intervention for MPFL insufficiency and resultant patellar instability1. Our objective was to develop a model to evaluate MPFL isometry2 at multiple candidate femoral attachment sites in the setting of patella alta. We hypothesized that a femoral attachment location proximal to that previously described by Schoettle et al would produce a more anatomometric MPFL in the setting of patella alta.Methods:Ten cadaveric knees were stripped of soft tissue leaving the patellar tendon, extensor mechanism, and collateral ligaments. A suture anchor was placed at the upper 41%3 of the medial border of the patella for MPFL reconstruction. The suture emanating from the anchor was utilized as a surrogate MPFL graft. Four separate locations about the medial aspect of the femur were evaluated as candidate attachment sites; that which was described by Schoettle (p00), 5 and 10 mm proximal (p05 & p10) as well as 5 mm distal (d05) to th...