Medial patellofemoral ligament reconstruction using a hamstring graft

Abstract

Recurrent lateral dislocation of the patella has been historically treated with a combination of multiple techniquesincluding lateral release, proximal realignment, medial reefing, and distal realignment. Poor-quality medial retinacular tissues and nonanatomic surgical attempts to restrain the patella may contribute to notable problems with redislocation and anterior knee pain. Recent biomechanical studies have identified the functional importance of the medial patellofemoral ligament as the primary restraint to lateral translation of the patella. A technique of reconstruction of this ligament with a single semitendinosis autograft, which provides a sturdy check-rein to lateral translation, is described. The authors' current indications for this procedure are (1) the recurrent lateral patellar dislocations in a patient with poor-quality medial soft tissues and no definable MPFL, and (2) the failure of previous proximal or proximal and distal realignment procedures with continued medial functional deficiency.