Arthroscopy assisted MPFL reconstruction by anatomic inverted ‘V’ tunnels placement technique

Abstract

Background: The medial patellofemoral complex, consisting of the medial patellofemoral ligament (MPFL) and the medial patellotibial ligament, is the main passive stabilizer of the patellofemoral joint. Since it has been shown that rupture of the MPFL is the main pathological consequence of patellar dislocation and biomechanical studies have demonstrated that the MPFL is the main passive restraint against patellofemoral instability (PFI) and lateral patellar displacement. Materials and methods: In 13 patients of post traumatic recurrent dislocation of patella, arthroscopy assisted minimally invasive MPFL reconstruction was done between March 2011 and July 2014, reconstruction was done with the hamstring tendon graft. Results: All the patients were treated successfully, on 1 and 2 year follow up they were able to walk and run well without the apprehension of dislocation of patella, Range of movement improved to complete flexion in 11 patients. 1 patient c/o stiffness of knee, 1 patient had minimal infection. No other significant post operative complications were seen. Conclusion: Since the recurrent dislocation of patella is a bothersome condition and most of the cases are associated with MPFL tear. Reconstruction of the MPFL has become a widely accepted for restoration of patellofemoral stability and it can be treated well with the minimally invasive arthroscopy assisted MPFL reconstruction technique. Results are encouraging and rehabilitation of the patient is early. Satisfaction level of the patient as well as the Surgeon is pretty good.