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We evaluated patellar tracking in six cadaveric knees with the medial restraints intact and then sectioned to determine their contribution to lateral translation of the patella with and without a lateral force on the patella. The medial patellofemoral ligament was then reconstructed with a gracilis tendon graft and patellar tracking was again evaluated. The knees were extended using a materials testing machine, and patellar tracking was measured with a position sensing system. With no lateral force applied to the patella, patellar tracking was unaffected by the presence or absence of the medial restraints or by reconstruction of the medial patellofemoral ligament. With a lateral force applied to the patella, patellar tracking was changed significantly by the loss of the medial restraints. Normal patellar tracking was substantially restored by reconstruction of the medial patellofemoral ligament.

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