Anatomic medial patellofemoral ligament reconstruction using patellar suture anchor fixation for recurrent patellar instability

Abstract

Case series with no comparison group, Level IV.

The double-pulley technique for anatomical double-bundled medial patellofemoral ligament reconstruction

“…_ 2 ) T D $ F I G ] Among all the different double-bundled MPFL reconstruction procedures described in the literature so far, majority of them vary in the methods of patellar fixation, which can be categorised into looping though bone-tunnels [24][25][26], partial bone drilling with aperture interference screw fixation with interference [27][28][29][30], and patellar rim fixation with suture anchors [31][32][33][34]. Among them, we believe patellar rim fixation with suture anchors theoretically offers the most advantages than the bone-tunnel and interference screw fixation techniques.…”

“…One patient reported postoperative dislocation and three knees had a persistent apprehension sign. Song et al [33] prospectively studied 20 patients (20 knees) who underwent MPFL reconstruction for recurrent patellar instability using a hamstring autograft fixed with two suture anchors at the patellar end. After a mean follow-up of 34.5 years, both Kujala and Lysholm scores improved significantly from 52.6 and 49.2 preoperatively to 90.9 and 90.9 postoperatively, respectively.…”

Double Bundle Medial Patellofemoral Ligament Reconstruction

“…This is because less exposure is required, as looping the graft through the lateral facet of the patella or to expose the bone tunnels is not necessary. Corroborating the opinion of Song et al [9], another advantage is that it is a relatively simple technique, which results in shorter surgical time and decreased exposure to radiation.…”

“…Bone tunnels were also demonstrated to enable better integration of the graft. As stated by Song et al [9], tendon-to-bone healing also occurs in the anchor…”

“…Thus, reconstruction of the two bands could increase the stability during the first flexion angles around 30°. The function of the MPFL at greater angles requires more elucidative studies [8][9][10][11][12][13][14][15].…”