title: Soft-Tissue Loop for Medial Patellofemoral Ligament Reconstruction.
abstract: A patient with patellar instability frequently presents with anterior knee pain, patellar subluxation, or dislocation. Medial patellofemoral ligament (MPFL) has a key role for normal patella tracking and stability. Reconstruction of the MPFL using a hamstring graft is a commonly used procedure for the treatment of chronic lateral subluxation of patella. Anchor sutures and bony tunnels are used for the patellar attachment of the graft. This can be associated with complications such as patella fracture; besides, it does not produce an anatomical reconstruction for the native MPFL that can alter the direction of tension applied on the patella. To overcome these problems, a soft-tissue loop technique is used for MPFL reconstruction. During this procedure, a semitendinosus graft was passed through the prepatellar extensor retinaculum and secured with sutures. The free ends of the graft were then passed between the second and third layers of the medial patellofemoral retinaculum and fixed to a femoral tunnel on the medial femoral condyle with an interference screw. The desired amount of tension on the graft is achieved under direct vision of patella tracking arthroscopically. We found this method to be relatively safe and fast. It is more anatomical and can avoid the complications during the conventional bony procedures.
authors.affiliation: Discipline of Orthopaedic, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.
authors.forename: Mohd Fairudz Bin Mohd
authors.initials: MF
authors.lastname: Miswan
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: Mohamed Zubair Mohamed
authors.initials: MZ
authors.lastname: Al-Fayyadh
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: Teo
authors.initials: T
authors.lastname: Seow Hui
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: Mohamed Razif Bin
authors.initials: MR
authors.lastname: Mohamed Ali
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: Wuey Min
authors.initials: WM
authors.lastname: Ng