TOTBİD Dergisi

TOTBİD Dergisi

2022, Cilt 21, Sayı, 4     (Sayfalar: 422-429)

Surgical techniques for medial patellofemoral ligament reconstruction in adults

Deniz Gülabi 1, Mustafa Çalışkan 1, Bülent Kılıç 1

1 T.C. Sağlık Bakanlığı, Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul

DOI: 10.5578/totbid.dergisi.2022.58
Görüntüleme: 79
İndirme : 47

The coordinated functioning of static, dynamic, and osseous restraints provides patellofemoral joint stability. Medial patellofemoral ligament (MPFL) is the most important static soft tissue constraint that provides resistance to lateral instability of the patella. Lateral dislocation of the patella usually leads to MPFL tear, and MPFL reconstruction is performed either in isolation or combination with bone procedures, depending on the underlying pathology. Although many different surgical techniques have been described in MPFL reconstruction, there is no consensus in the literature on which surgical technique should be the standard approach. However, most applied surgical techniques imitate normal anatomy and fix the MPFL to the patellar and femoral attachments in ideal isometry. The surgical technique generally consists of many stages such as, knee examination under anesthesia, arthroscopic examination of the knee, fixation of the graft to the patella, creation of the patellofemoral interval, determination of the femoral attachment site, preparation of the femoral tunnel, and femoral graft fixation. Each stage differs according to the technique applied and has varying effects on surgical success. Complications are usually due to surgical technique errors. This review article explains the approach we follow in MPFL reconstruction, different techniques in the literature, and possible complications.

Anahtar Kelimeler : patellar instability; patellar dislocation; medial patellofemoral ligament; femoral attachment