Avoiding Complications with MPFL Reconstruction

Current Reviews in Musculoskeletal Medicine
Marvin K SmithDavid R Diduch

Abstract

To discuss the potentially significant complications associated with medial patellofemoral ligament (MPFL) reconstruction. Additionally, to review the most current and relevant literature with an emphasis on avoiding these potential complications. Multiple cadaveric studies have characterized the anatomy of the MPFL and the related morphologic abnormalities that contribute to recurrent lateral patellar instability. Such abnormalities include patella alta, excessive tibial tubercle to trochlear grove (TT-TG) distance, trochlear dysplasia, and malalignment. Recent studies have evaluated the clinical outcomes associated with the treatment of concomitant pathology in combination with MPFL reconstruction, which is critical in avoiding recurrent instability and complications. Although there remains a lack of consensus regarding various critical aspects of MPFL reconstruction, certain concepts remain imperative. Our preferred methods and rationales for surgical techniques are described. These include appropriate work up, a combination of procedures to address abnormal morphology, anatomical femoral insertion, safe and secure patellar fixation, appropriate graft length fixation, and thoughtful knee flexion during fixation.

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Citations

Jan 27, 2020·Current Reviews in Musculoskeletal Medicine·Evan E VelliosJennifer J Beck
May 28, 2019·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Filippo MiglioriniJörg Eschweiler
Oct 21, 2018·Skeletal Radiology·Neeraj PurohitAsif Saifuddin
Aug 1, 2020·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Jakob AckermannAndreas H Gomoll
Jan 21, 2021·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Eoghan T HurleyEric J Strauss
Feb 19, 2021·Medical & Biological Engineering & Computing·Jeffry HartantoTet Sen Howe
Feb 23, 2021·Orthopaedic Journal of Sports Medicine·Juan Pablo Martinez-CanoAlfredo Martinez-Rondanelli

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