Squeaking knee joint after reconstruction of the medial patellofemoral ligament

Introduction: Reconstruction of the medial patellofemoral ligament (MPFL) with a free gracilis or semitendinosus tendon graft has been a successful treatment for chronic patellofemoral instability between 0° and 30° of knee flexion for many years. An implant-free graft attachment on the medial facet of the patella has been shown to provide successful results. Case report: A 26-year-old female patient was treated with MPFL reconstruction of the right knee joint. At 3 months postoperatively the patient reported a disturbing “squeaking” in the operated knee. Arthroscopic revision showed an intra-articular position of the implanted suture material at the lateral patella facet. Conclusion: The use of implant-free tendon attachment to the patella during MPFL reconstruction has been a well-established procedure for many years with a good rate of healing. Decisive is the parallel drilling to the patellar surface, which can be intraoperatively controlled radiologically and arthroscopically. It is important to avoid intra-articular placement of suture material during this type of surgery in order to prevent the rare occurrence of joint squeaking. © 2018, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.