A Modified method for reconstruction of the medial patellofemoral ligament using quadriceps tendon: a technical tip and results
DOI:
https://doi.org/10.1016/j.rccot.2020.04.011Keywords:
patellar ligament, quadriceps muscle, patellar dislocation, joint instabilityAbstract
Background: Patellar instability and recurrent dislocation is a prevalent disorder in children and adolescents that require surgical repair of the medial patellar femoral ligament (MPFL), paying particular attention in preserving the open growth plates in this population.
Methods: We describe a modified method for reconstruction of the medial patellofemoral ligament using an autograft from the quadriceps tendon, which is attached with anchor sutures to the epiphysial isometric point of the MPFL insertion. Since 2012, this technique has been used in pediatric patients in our institution; here, we present the long-term results of this cohort.
Results: We have used this technique in 5 patients with patellar instability with recurrent patellar dislocation with a median postsurgical follow-up time of four years (range 2-5 years). The median preoperative Insall-Salvati ratio was 1.41. The median Kujala score before and after surgery during the last evaluation was 76.5 (range 34-100) and 98.5 (range 75-100), respectively. No cases of redislocation or episodes of subluxation were present during the follow-up. One patient presented West syndrome which made difficult pre and postoperative objective assessment; however, his results were satisfactory.
Discussion: This modified method constitutes an alternative technique of graft fixation, that in our experience, provides satisfactory results, with patellar stability caused by fixed graft tension. In the operated patients, no recurrences nor complications have been present.
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References
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