title: A mini-invasive adductor magnus tendon transfer technique for medial patellofemoral ligament reconstruction: a technical note.
abstract: Patellar dislocations are associated with injuries to the medial patellofemoral ligament (MPFL). Several techniques for MPFL reconstruction have been recently published with some disadvantages involved, including large skin incisions and donor site morbidity. Arthroscopic stabilizing techniques carry the potential of inadequate restoration of MPFL function. We present a minimally invasive technique for MPFL reconstruction using adductor magnus tendon autograft. This technique is easily performed, safe, and provides a stabilizing effect equal to current MPFL reconstructions. Skin incision of only 3-4 cm is located at the level of the proximal half of the patella. After identifying the distal insertion of the adductor magnus tendon, a tendon harvester is introduced to harvest the medial two-thirds of the tendon, while the distal insertion is left intact. The adductor magnus tendon is cut at 12-14 cm from its distal insertion and transferred into the patellar medial margin. Two suture anchors are inserted through the same incision at the superomedial aspect of the patella in the anatomic MPFL origin. The graft is tightened at 30 degrees knee flexion. Aftercare includes 4 weeks of brace treatment with restricted range of motion.
authors.affiliation: Research Unit, Centre for Military Medicine, Lahti, Finland. petri.sillanpaa@uta.fi
authors.forename: Petri J
authors.initials: PJ
authors.lastname: Sillanpää
authors.forename: Heikki M
authors.initials: HM
authors.lastname: Mäenpää
authors.forename: Ville M
authors.initials: VM
authors.lastname: Mattila
authors.forename: Tuomo
authors.initials: T
authors.lastname: Visuri
authors.forename: Harri
authors.initials: H
authors.lastname: Pihlajamäki
mesh_terms: D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D031222:Patellar Dislocation / Q000601:surgery*; D017847:Patellar Ligament / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D013709:Tendon Transfer / Q000379:methods*