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A mini-invasive adductor magnus tendon transfer technique for medial patellofemoral ligament reconstruction: a technical note
Authors:Petri J. Sillanpää  Heikki M. Mäenpää  Ville M. Mattila  Tuomo Visuri  Harri Pihlajamäki
Affiliation:(1) Research Unit, Centre for Military Medicine, Lahti, Finland;(2) Department of Orthopedic Surgery and Trauma, Tampere University Hospital, Tampere, Finland;(3) Research Department, Centre for Military Medicine, P.O. Box 50, Helsinki, Finland;(4) Department of Orthopedic Surgery, Central Military Hospital, Helsinki, Finland;(5) Teiskontie 25, PL 2000, 33521 Tampere, Finland
Abstract:Patellar dislocations are associated with injuries to the medial patellofemoral ligament (MPFL). Several techniques for MPFL reconstruction have been recently published with some disadvantages involved, including large skin incisions and donor site morbidity. Arthroscopic stabilizing techniques carry the potential of inadequate restoration of MPFL function. We present a minimally invasive technique for MPFL reconstruction using adductor magnus tendon autograft. This technique is easily performed, safe, and provides a stabilizing effect equal to current MPFL reconstructions. Skin incision of only 3–4 cm is located at the level of the proximal half of the patella. After identifying the distal insertion of the adductor magnus tendon, a tendon harvester is introduced to harvest the medial two-thirds of the tendon, while the distal insertion is left intact. The adductor magnus tendon is cut at 12–14 cm from its distal insertion and transferred into the patellar medial margin. Two suture anchors are inserted through the same incision at the superomedial aspect of the patella in the anatomic MPFL origin. The graft is tightened at 30° knee flexion. Aftercare includes 4 weeks of brace treatment with restricted range of motion.
Keywords:Patella  Medial patellofemoral ligament  Injury  Mini-invasive surgery  Reconstruction  Knee
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