A Novel Approach
نویسنده
چکیده
Recently, medial patellofemoral ligament reconstruction has gained popularity as a treatment modality for recurrent patellar instability.2-6 Patients who have failed surgical interventions including lateral release, medial patellofemoral ligament reefing, and distal realignment may be good candidates for medial patellofemoral ligament reconstruction. The anatomy and biomechanics of the medial patellofemoral ligament have been well described. Anatomically, the medial patellofemoral ligament extends between the superomedial pole of the patella to the anterior aspect of the medial epicondyle in layer 2 of the medial soft-tissue structures.8 The patellar insertion is wider than the femoral origin. The vertical distance from the superior pole of the patella to the top of the medial patellofemoral ligament averages about 6.1 mm.8 The inferior edge of the medial patellofemoral ligament is located near the midpoint of the patella. On the femoral side, the medial patellofemoral ligament inserts on the entire height of the medial epicondyle. Biomechanically, the medial patellofemoral ligament is considered the primary passive restraint to patellar lateral displacement, with a mean tensile strength of 208 N.1 This article presents a novel, minimally invasive approach to reconstruct the medial patellofemoral ligament anatomically, a bio-interference screw to achieve fixation in the femur, and a knotless suture anchor to achieve fixation in the patella.
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