title: Reconstruction of the medial patellofemoral ligament using a longitudinal patellar tunnel technique.
abstract: Patellar instability is a common clinical problem affecting a young, active population. A large number of procedures have been described to treat patellar instability. We present the clinical results in a case series of 25 medial patellofemoral ligament reconstructions in 21 patients with up to 30 months follow-up (mean: 7.3). Reconstruction was performed using either the gracilis or semitendinosus tendon autograft. The Tegner activity score improved overall from 3 to 4.4 at follow-up and the mean follow-up Kujala score was 87 (range: 55-100). No patella redislocations were observed. Five patients (20%) required a manipulation under anaesthetic but subsequently regained a satisfactory range of motion. Medial patellofemoral reconstruction with both gracilis and semitendinosus tendon graft using a longitudinal tunnel technique provided good post-operative stability restoring the primary soft tissue restraint to pathological lateral patellar displacement with no complications of post-operative patellar fracture.
authors.affiliation: Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Devon, UK. jonjmatthews@googlemail.com
authors.forename: Jon J
authors.initials: JJ
authors.lastname: Matthews
authors.forename: Peter
authors.initials: P
authors.lastname: Schranz
mesh_terms: D000293:Adolescent; D000328:Adult; D050376:Bone-Patellar Tendon-Bone Grafting / Q000379:methods*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D017888:Medial Collateral Ligament, Knee / Q000601:surgery*; D031222:Patellar Dislocation / Q000601:surgery*; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation; D055815:Young Adult