title: Technical failure of medial patellofemoral ligament reconstruction.
abstract: In patients with chronic patellofemoral instability who have normal alignment and deficient proximal medial restraints, medial patellofemoral ligament (MPFL) reconstruction is a good option to treat patellar instability. However, medial subluxation, medial patellofemoral articular overload, and recurrent lateral instability are possible when the graft is positioned non-anatomically. The clinical presentation of MPFL femoral tunnel malpositioning has not been highlighted in the literature. We have had 5 patients referred to us after a malpositioned femoral MPFL graft led to disabling symptoms and a need for revision surgery. This report highlights the effects of a malpositioned graft and describes strategies to identify the anatomic MPFL insertion during surgery.
authors.affiliation: Department of Orthopaedic Surgery, University of Iowa, Iowa City, Iowa 52240, USA. mattbollier@yahoo.com
authors.forename: Matthew
authors.initials: M
authors.lastname: Bollier
authors.forename: John
authors.initials: J
authors.lastname: Fulkerson
authors.forename: Andy
authors.initials: A
authors.lastname: Cosgarea
authors.forename: Miho
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000293:Adolescent; D000328:Adult; D001178:Arthroplasty; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries / Q000601:surgery*; D057071:Patellofemoral Joint / Q000293:injuries / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012086:Reoperation; D017211:Treatment Failure