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Combined Medial Patellofemoral Ligament and Medial Patellotibial Ligament Reconstruction
Book Title
Anterior Knee Pain and Patellar Instability
Files
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Editors
[Sanchis-Alfonso] [Vincente]
Description
Lateral patellar dislocations are a common, potentially debilitating injury that occurs in young athletes. While the medial patellofemoral ligament (MPFL) is the primary ligamentous restraint to lateral patellar translation, the MPTL and medial patellomeniscal ligament (MPML) also play integral roles in patella kinematics. Biomechanical studies have shown that the MPTL is responsible for nearly 25% of restraint in extension and the combined MPTL/MPML complex provides 46% of the restraint at 90° of flexion. The indications for MPTL reconstruction are evolving, and can include patients with subluxation in extension, flexion instability, children with risk factor for recurrence, knee hyperextension and/or an increased quadriceps vector due to rotational deformities. For reconstruction of the distal medial patellotibial complex, a variety of surgical options are available and are discussed. The authors’ preferred technique is a combined MPFL, MPTL reconstruction using a tibialis anterior allograft. While the long-term outcomes are scarcely described in the literature, the available data suggests that several of these procedures are effective at preventing subsequent dislocations or instability events in select high risk situations, while also providing pain and functional relief to a young and active patient population.
First Page
445
Last Page
459
ISBN
973-3-031-09766-9
Publication Date
2023
Publisher
Springer Nature
City
Cham, Switzerland
Keywords
MPFL, MPTL, knee, reconstruction
Disciplines
Orthopedics | Surgery
Recommended Citation
Dean RS, Hincke BB, Arendt EA. Combined medial patellofemoral ligament and medial patellotibial ligament reconstruction. In: Sanchis-Alfonso V, editor. Anterior knee pain and patellar instability. 3rd ed. Cham (Switzerland): Springer Nature; 2023. p. 445-59. doi:10.1007/978-3-031-09767-6.
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