Hamstring graft fixation in MPFL reconstruction at the patella using a transosseous suture technique.
Controversy still exists about fixation methods of a hamstring graft to the patella in case of medial patellofemoral ligament (MPFL) reconstruction. This article presents a surgical technique of hamstring tendon graft fixation to the anatomical MPFL insertion on the patella using transosseous sutures. A superficial bony sulcus is created at the anatomical MPFL insertion site on the medial patellar rim with a bur. A looped hamstring tendon graft is fixed to this superficial sulcus by a pair of nonresorbable transosseous sutures passed across the patella. The retinaculum is sutured on top of the hamstring tendon graft at the level of the patella for additional fixation. The technique avoids bone tunnels as well as hardware at the patella. It reduces the risk of intraoperative or postoperative patella fracture or implant-related complications. The stable transosseous fixation technique allows for early rehabilitation.
Siebold
Rainer
R
Center for Knee and Foot Surgery, Sportstraumatology, ATOS Hospital Heidelberg, Bismarckstrasse 9-15, Heidelberg, Germany. rainer.siebold@atos.de
Chikale
Shivanand
S
Sartory
Nico
N
Hariri
Nawid
N
Feil
Sven
S
Pässler
Hans H
HH
D001864:Bone Wires; D005260:Female; D006085:Graft Survival; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D017888:Medial Collateral Ligament, Knee / Q000601:surgery*; D031222:Patellar Dislocation / Q000601:surgery*; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D018570:Risk Assessment; D013314:Stress, Mechanical; D013536:Suture Techniques; D013710:Tendons / Q000637:transplantation; D013718:Tensile Strength; D016896:Treatment Outcome
Arch Orthop Trauma Surg. 2008 May;128(5):479-84
17323067
Acta Orthop Belg. 2006 Jan;72(1):65-71
16570897
J Bone Joint Surg Am. 1974 Jun;56(4):665-74
4835814
J Bone Joint Surg Am. 1981 Mar;63(3):351-6
7204430
Knee Surg Sports Traumatol Arthrosc. 2002 May;10(3):138-40
12012030
Arthroscopy. 2005 Feb;21(2):130-7
15689860
Knee. 2003 Sep;10(3):215-20
12893142
Knee Surg Sports Traumatol Arthrosc. 2008 Jan;16(1):40-3
17973099
Clin Orthop Relat Res. 1999 Feb;(359):151-5
10078138
J Bone Joint Surg Br. 2005 Jan;87(1):36-40
15686235
Arthroscopy. 2007 Jan;23(1):108.e1-4
17210439
J Bone Joint Surg Br. 2005 Apr;87(4):577-82
15795215
Arthroscopy. 2005 Mar;21(3):365-70
15756193
Am J Sports Med. 1996 Jan-Feb;24(1):52-60
8638754
Arthroscopy. 2004 Feb;20(2):147-51
14760346
Arthroscopy. 2008 Jan;24(1):82-7
18182207
Am J Sports Med. 2007 Mar;35(3):484-92
17303819
J Bone Joint Surg Am. 1977 Mar;59(2):213-7
845207
J Bone Joint Surg Am. 1993 May;75(5):682-93
8501083
J Knee Surg. 2008 Jul;21(3):241-5
18686487
J Bone Joint Surg Am. 2009 Mar 1;91(3):521-9
19255211
Arthroscopy. 2003 May-Jun;19(5):E47
12724671
Am J Sports Med. 1998 Jan-Feb;26(1):59-65
9474403
Clin Orthop Relat Res. 1998 Apr;(349):174-82
9584380
J Bone Joint Surg Am. 2007 Sep;89(9):2000-10
17768198
Knee Surg Sports Traumatol Arthrosc. 2005 Oct;13(7):516-21
15959766