title: Dynamic medial patellofemoral ligament reconstruction in recurrent patellar instability: A surgical technique.
abstract: The medial patellofemoral ligament (MPFL) is the primary stabilizer of the patellofemoral joint; its reconstruction has been recommended in adults over the past decade after recurrent patellar instability. However, there has been no standardized technique for reconstruction, therefore, ideal graft and technique for reconstruction are yet undetermined. However, dynamic MPFL reconstruction studies claim to be superior to other procedures as it is more anatomical. This preliminary study aims at assessing the outcomes of MPFL reconstruction in a dynamic pattern using hamstring graft. We performed this procedure in four consecutive patients with chronic patellar instability following trauma. MPFL reconstruction was done with hamstring tendons detached distally and secured to patellar periosteum after being passed through a bony tunnel in the patella without an implant and using the medial collateral ligament as a pulley. In all 4 knees, the MPFL reconstruction was isolated and was not associated with any other realignment procedures. No recurrent episodes of dislocation or subluxation were reported at 24 months followup.
authors.affiliation: Department of Orthopaedics, Dr. PSIMS and RF, Chinoutpalli, India.
authors.forename: Kopuri Ravi
authors.initials: KR
authors.lastname: Kiran
authors.affiliation: Department of Orthopaedics, ASHRAM, Eluru, Andhra Pradesh, India.
authors.forename: I Muni
authors.initials: IM
authors.lastname: Srikanth
authors.affiliation: Department of Orthopaedics, Apolo Hospitals, Chennai, Tamil Nadu, India.
authors.forename: Lenin
authors.initials: L
authors.lastname: Chinnusamy
authors.affiliation: Department of Radiodiagnosis, TIME Hospitals, Vijayawada, Andhra Pradesh, India.
authors.forename: K
authors.initials: K
authors.lastname: Deepti
keywords: Hamstrings; Patellar dislocation; Q-angle; dislocations; ligaments; medial collateral ligament pulley; medial patellofemoral ligament; recurrent patellar instability