Medial Patellofemoral Ligament Reconstruction- State of the Art

Benjamin F Sandberg, Marc A Tompkins

Volume 3 | Issue 1 | Jan – Apr 2018 | Page 17-23

Author: Benjamin F Sandberg [1], Marc A Tompkins [1,2]

[1] The Orthopaedic Speciality Clinic, Wrangler Paranjpe Road, Pune
[2] Head, Translational Medicine & Research, SRM University, Kattankulathur, Tamil Nadu

Address of Correspondence
Dr. Sachin Ramchandra Tapasvi,
The Orthopaedic Speciality Clinic, Wrangler Paranjpe Road, Pune
Email: stapasvi@gmail.com

Abstract

The management of recurrent patellar instability has undergone progressive changes over the past few decades with improved optimal and predictable outcomes for the patients. Open surgical realignment procedures with bony osteotomies either proximal or distal to the Patella, designed to correct the imbalance of the extensor mechanism such that the patella tracks smoothly over the trochlea were commonly advocated. These procedures aimed to restore normal chondral loading of the patellofemoral joint and modify or delay progression of arthritic changes at an early age. With enhanced knowledge on the biomechanics of the anatomical structures providing medial and lateral restraints around the knee, the role of the Medial Patello-Femoral Ligament has been shown to be a vital one. This has refined the surgical options available to minimally invasive arthroscopic approaches with satisfying calculable results. This review article outlines the evolution of the surgical management of patellar instability and the prominent role of the MPFL reconstruction in achieving it. The biomechanics, surgical principles, anatomic landmarks, types of grafts and fixation methods, along with the senior surgeon’s preferred surgical technique are described in detail.
Keywords: Recurrent patellar instability, Medial Patello-Femoral Ligament, reconstruction.

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