title: Reconstruction of the medial patellofemoral ligament using the adductor magnus tendon: an anatomic study.
abstract: OBJECTIVE
  The aims of this study were to evaluate the anatomic feasibility of medial patellofemoral ligament (MPFL) reconstruction using a part of the adductor magnus tendon and to identify possible risks.
  
  
  METHODS
  Twenty cadaveric knees were dissected. The distal part of the adductor magnus tendon was evaluated with respect to the anatomic topography and its utility for MPFL reconstruction. To estimate the risk of injuring the neurovascular structures, the distance from the adductor tubercle to the adductor hiatus was evaluated. An MPFL reconstruction was carried out by preserving the distal insertion on the adductor tubercle and redirecting the proximal portion of the tendon to the medial aspect of the patella.
  
  
  RESULTS
  The anatomic investigation showed the following relationships: The mean distance from the adductor tubercle to the adductor hiatus was 99 ± 14 mm (range, 80 to 120 mm). A graft length of 52 ± 5 mm (range, 45 to 63 mm) with the addition of 10 to 20 mm for fixation was found to be necessary for MPFL reconstruction. The difference between the desired graft length and the distance to the adductor hiatus was found to be at least 30 mm in all cases (mean, 46 mm). Leaving the graft attached to the adductor tubercle resulted in a nearly anatomic femoral attachment of the reconstructed MPFL. Complete detachment of the distal adductor magnus attachment was consistently avoidable.
  
  
  CONCLUSIONS
  The adductor magnus tendon was found to be a useful graft for MPFL reconstruction. However, anatomic dangers (damage to the neurovascular bundle of the adductor hiatus, the saphenous nerve, or the saphenous branch of the descending genicular artery) during graft harvest must be considered.
  
  
  CONCLUSIONS
  Anatomic knowledge is essential during adductor magnus tendon harvest to avoid damage to neurovascular structures. The adductor magnus tendon is an interesting alternative graft option for MPFL reconstruction if anatomic dangers are considered and avoided.
authors: Orthopädie am Rosenberg, St. Gallen, Switzerland. ortho@mjacobi.ch
authors: Matthias
authors: M
authors: Jacobi
authors: Nikolaus
authors: N
authors: Reischl
authors: Mathias
authors: M
authors: Bergmann
authors: Samy
authors: S
authors: Bouaicha
authors: Valentin
authors: V
authors: Djonov
authors: Robert A
authors: RA
authors: Magnussen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D017888:Medial Collateral Ligament, Knee / Q000601:surgery*; D017847:Patellar Ligament / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013710:Tendons / Q000601:surgery*; D013718:Tensile Strength; D016378:Tissue Transplantation / Q000379:methods