Medial Patellofemoral Ligament Reconstruction

Medial patellofemoral reconstruction is used to treat episodic lateral patellar instability that is due to laxity of medial retinacular patellar stabilizers. The ideal candidate has minimal pain between episodes of patellar instability, and seeks medical care primarily to address the occasional dislocation or subluxation. This technique will not reliably treat patellofemoral pain that is not directly caused by instability episodes. After exam under anesthesia and diagnostic arthroscopy, two right angle tunnels are drilled into the superomedial patella and a blind socket is created midway between the adductor tubercle and the epicondyle. A semitendinosus autograft or allograft is fixated at the femoral tunnel with an interference screw, tunneled between layers two and three, and then each limb is pulled through the patellar tunnels before being sutured to itself over a patellar bone bridge. This surgical method aims to reestablish a check-rein against lateral patellar motion and to reestablish normal limits of passive lateral patellar motion. Oper Tech Sports Med 18:93-97 (C) 2010 Elsevier Inc. All rights reserved.