title: Hamstring graft fixation in MPFL reconstruction at the patella using a transosseous suture technique.
abstract: 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.
authors.affiliation: Center for Knee and Foot Surgery, Sportstraumatology, ATOS Hospital Heidelberg, Bismarckstrasse 9-15, Heidelberg, Germany. rainer.siebold@atos.de
authors.forename: Rainer
authors.initials: R
authors.lastname: Siebold
authors.forename: Shivanand
authors.initials: S
authors.lastname: Chikale
authors.forename: Nico
authors.initials: N
authors.lastname: Sartory
authors.forename: Nawid
authors.initials: N
authors.lastname: Hariri
authors.forename: Sven
authors.initials: S
authors.lastname: Feil
authors.forename: Hans H
authors.initials: HH
authors.lastname: Pässler
mesh_terms: 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
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