title: Anatomical two-bundle medial patellofemoral ligament reconstruction with hardware-free patellar graft fixation: technical note and preliminary results.
abstract: OBJECTIVE
  Various techniques for reconstruction of the medial patellofemoral ligament (MPFL) have been developed. In this article, a modified technique for anatomical two-bundle MPFL reconstruction with hardware-free patellar graft fixation is described and the preliminary results of this technique are presented.
  
  
  METHODS
  A modified surgical technique for MPFL reconstruction with a gracilis tendon autograft and hardware-free patellar graft fixation using two short oblique bone tunnels is described in detail. Complications and preliminary results of this procedure were assessed in 19 patients at a mean follow-up of 16 ± 3 months using the Kujala score, Tegner scale, and Insall score.
  
  
  RESULTS
  No postoperative patellar dislocation or subluxation was reported. Eighty-nine per cent of the patients were either satisfied or very satisfied with the overall outcome. The mean Kujala score was 92 ± 7 (range 69-100), and the median Tegner scale was 5 (range 3-7). According to the Insall score, the results of 18 patients (95%) were rated as good or excellent. Postoperative complications occurred in 3 patients (16%), with two of them persisting only temporary.
  
  
  CONCLUSIONS
  The described technique for anatomical two-bundle MPFL reconstruction is a safe and effective surgical procedure for the treatment of lateral patellar instability, with several methodical advantages compared to similar techniques. Further evaluation in a larger patient cohort with a longer follow-up is necessary to confirm these short-term results.
  
  
  METHODS
  IV.
authors.affiliation: Department for Orthopedic Sports Medicine, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hinterwimmer
authors.forename: Andreas B
authors.initials: AB
authors.lastname: Imhoff
authors.forename: Philipp
authors.initials: P
authors.lastname: Minzlaff
authors.forename: Tim
authors.initials: T
authors.lastname: Saier
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Rosenstiel
authors.forename: Wolfried
authors.initials: W
authors.lastname: Hawe
authors.forename: Matthias J
authors.initials: MJ
authors.lastname: Feucht
mesh_terms: D000293:Adolescent; D000328:Adult; D064592:Autografts; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008023:Ligaments, Articular / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D031222:Patellar Dislocation / Q000601:surgery*; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods*; D013710:Tendons / Q000637:transplantation; D016896:Treatment Outcome; D055815:Young Adult