Medial Patellofemoral Ligament Reconstruction and Lateral Retinacular Lengthening from a Lateral Approach

S Brandon Luczak; John W Stelzer; Kevin P Fitzsimmons; J Lee Pace

doi:10.1016/j.eats.2020.11.018

Medial Patellofemoral Ligament Reconstruction and Lateral Retinacular Lengthening from a Lateral Approach

Arthrosc Tech. 2021 Mar 8;10(4):e987-e994. doi: 10.1016/j.eats.2020.11.018. eCollection 2021 Apr.

Authors

S Brandon Luczak¹, John W Stelzer¹, Kevin P Fitzsimmons², J Lee Pace^{1

2}

Affiliations

¹ University of Connecticut Health and School of Medicine, Department of Orthopedic Surgery, Farmington, Connecticut, U.S.A.
² Elite Sports Medicine @ Connecticut Children's Medical Center, Farmington, Connecticut, U.S.A.

Abstract

The medial patellofemoral ligament (MPFL) is frequently torn and attenuated in patients with acute or chronic patellar instability. The mainstay for surgical treatment has become MPFL reconstruction to reestablish the checkrein to lateral patellar translation. The authors describe a technique for MPFL reconstruction with concomitant lateral retinacular lengthening with a gracilis allograft and adjustable loop cortical femoral fixation performed chiefly from a lateral parapatellar approach. This technique allows for reliable retensioning of the medial and lateral patellar soft tissues while avoiding complications associated with techniques that use interference screw fixation. Successful execution of this procedure provides a strong MPFL construct that allows patients to undergo early aggressive rehabilitation and return to activities.