title: Complications and failure of MPFL reconstruction with free tendon grafts in cases of patellofemoral instability.
abstract: BACKGROUND
  Reconstruction of the medial patellofemoral ligament (MPFL) using free tendon grafts has become a widespread treatment option for patellofemoral instability. As the numbers of cases gradually grow, so do the reports of possible peri- and postoperative complications following this procedure.
  
  
  OBJECTIVE
  The present review summarizes all known complications of MPFL reconstruction with regard to postoperative outcome and seeks to highlight possible pitfalls that may occur during treatment.
  
  
  CONCLUSIONS
  MPFL reconstruction generally has to be regarded as a safe procedure today due to low patellar re-dislocation rates. Complication rates however are not trivial owing to the complexity of the underlying pathology. Complications can arise from graft fixation or femoral tunnel placement. Postoperative flexion deficits and medial knee pain have been described as predominant complaints. Anatomical preconditions as the grade of trochlear dysplasia, axis or torsion of the lower extremity have to be considered in search of causes for possible graft failure as well as in the thorough preoperative planning of the procedure.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Paracelsus Medical University, Nürnberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Geßlein
authors.affiliation: Department of Orthopaedics and Traumatology, University Hospital Bonn, Bonn, Germany.
authors.forename: P P
authors.initials: PP
authors.lastname: Roessler
authors.affiliation: Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany.
authors.forename: K F
authors.initials: KF
authors.lastname: Schüttler
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Paracelsus Medical University, Nürnberg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Biber
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Paracelsus Medical University, Nürnberg, Germany.
authors.forename: H J
authors.initials: HJ
authors.lastname: Bail
authors.affiliation: Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Efe
mesh_terms: D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery*; D010146:Pain / Q000453:epidemiology; D057071:Patellofemoral Joint / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods*; D013710:Tendons / Q000637:transplantation*
keywords: Mediopatellofemoral ligament (MPFL); complications; patellofemoral instability