The purpose of the study - anatomical and biomechanical substantiation of medial patellofemoral ligament (MPFL) reconstruction in cases of recurrent patella dislocation. Material and methods. Anatomical studies were performed in 27 fresh frozen cadaver knees. Biomechanical study was made using video capture system with 5 specimens of the knee. In the first stage we examined the lateral displacement of the patella when the knee was flexing, and in the second - isometric properties of the MPFL. Results. In all cases MPFL was found between the knee capsule and the superficial fascia. In 6 (22.2%) cases singlebundle structure was revealed, in 14 (51.8%) - two-bundle and in 2 (7.4%) - three-bundle structure. In 2 (7.4%) knee joints MPFL was presented in one thinned bundle, attached to the upper third of the patella. The degree of the MPFL isometry was indicated by changing in the distance between the optical markers located in the regions of attachment of MPFL ligament. For all of the knees this distance had reached 58.3±1.2 mm tibia in knee flexion at 20°; 57.8±,4 mm - when flexed by 30°; 56.9±1,3 mm - at 45°; 56.8±1,3 mm - at 60° of flexion and 53.0±0,7 mm - at 90°. Conclusion. There are several variants of MPFL anatomical structure, and in most cases it has two bundles oriented to the medial surface of the knee from posterior to anterior and from proximal to distal directions. MPFL has a streak of isometry, as a normal characteristic of each anatomical ligament and this isometry must be followed in MPFL reconstruction in case of recurrent patella dislocation.

Injury of the anterior cruciate ligament (ACL) remains the most common cause leading to limited knee function and earlier development of gonarthrosis. The results of ACL repair in male and female patients remain heterogeneous. Women have worse results of surgical treatment, as well as higher risks of ACL injuries (from 1,5 to 10 times) when playing sports. It is assumed that the features of the anatomical structure of the knee play the key role in this joint. We have studied 40 unpaired anatomical preparations of the human knee joint obtained from women and men.The morphometry of the distal femoral epiphysis was performed using a digital sliding caliper according to 16 parameters. When examining the areas of femoral ACL attachment, their shape, size, area, and center distance from individual bone structures were assessed. The data obtained were correlated with the type of structure of the knee joint. Were studied the anatomical features characteristic of the "female" type of structure of the knee joint. It was found that the type of structure of the knee joint affects the topography of the femoral attachment area of the ACL, which must be taken into account in anatomical ligament reconstruction.

Complete traumatic injuries of the anterior cruciate ligament (ACL) are the most common knee injury among physically active males and females who are fond of both traditional and extreme sports. Surgical restoration of the anatomical structures of the injured joint, even with isolated ACL damage, remains an urgent problem of modern traumatology and orthopedics. The technology of arthroscopic reconstruction of the ACL is developing along the path of improving the technique of surgery, fixators, plastic materials. The article is devoted to the study of the results of arthroscopic anatomical plastic surgery of the anterior cruciate ligament with autografts from the patellar ligament with two bone blocks and the hamstring flexor tendons. The study included 100 patients of the main group and the comparison group with chronic damage to the anterior cruciate ligament and chronic anterior instability of the knee joint, which were divided into two groups depending on the type of transplant used. Long-standing injuries of the anterior cruciate ligament were diagnosed based on the results of a clinical examination, radiography, magnetic resonance imaging, and hardware arthrometry. Excellent and good results of surgical treatment were obtained in most patients of both groups, however, the highest stabilization indicators of the knee joint were noted in the comparison group.

Injuries to the anterior cruciate ligament of the knee joint, while remaining one of its most common types of injury, cause restriction of physical activity in people leading an active lifestyle, due to the occurrence of biomechanical disorder s. The generally accepted approach of surgical correction is aimed at replacing the lost structure in order to approach the motor norm of the preserved elements of the joint. The presented publication reflects the results of arthroscopic surgical reconstruction of the anterior cruciate ligament with an autograft from the patellar ligament by anatomical and transtibial methods. The main methods of diagnosing tears of the anterior cruciate ligament were clinical and instrumental studies, including manual testing, radiography, magnetic resonance imaging, hardware arthrometry. A total of 134 patients with long-standing damage to the anterior cruciate ligament and chronic anterior instability of the knee joint were treated, which were divided into two groups according to the method of plastic surgery. Complete recovery of the level of physical activity and return to sports were observed in the majority of patients of both clinical groups.