(Fig 4-A.42) MPFL Reconstruction and Lateral Release

https://youtu.be/L-tKNDxwvl8

https://youtu.be/vzxclU_34OI?si=B88NykUJHSELzyAC

 

==============================================

🎥 Check Out All Videos at Once! 📺

👉 Visit Visualizing MSK Blog to explore a wide range of videos! 🩻

https://visualizingmsk.blogspot.com/?view=magazine

📚 You can also find them on MSK MRI Blog and Naver Blog! 📖

https://mskmri.tistory.com/

https://blog.naver.com/mskmri

https://www.instagram.com/msk_mri/

Click now to stay updated with the latest content! 🔍✨

==============================================

📌MPFL Reconstruction

• Mainstay treatment for recurrent patellar dislocations
• Involves recreating the medial patellofemoral ligament (MPFL) using a tendon graft
• Proper femoral tunnel positioning is critical to avoid excessive cartilage loading

 

✅  Surgical Techniques

• Double-stranded gracilis tendon autograft commonly used
• Graft fixed to medial patella and femur with bone anchors
• May be combined with additional osseous procedures

 

✅  Adjunctive Procedures

• Trochleoplasty to reshape the trochlear groove
• Tibial tubercle osteotomy to unload lateral facet
• Derotational osteotomy to correct malrotation

 

✅  Complications of MPFL Reconstruction

• Graft failure, malposition, medial subluxation, patellar fracture
• Hardware issues
• Premature physeal closure in skeletally immature patients

 

▶️  Imaging Evaluation

• Low signal intensity of graft makes MPFL evaluation challenging on MRI
• Look for fluid-filled defects to detect graft tears

 

✅  Lateral Capsular Release 

• May contribute to patellofemoral instability near full extension
• Can cause excessive scarring and patellar tilt

 

References: Radiographics. 2023 Jun;43(6):e220177 RadioGraphics 2010; 30:961-981

#patellardislocation #MPFLreconstruction #trochleoplasty #tibialtubercleosteotomy #derotationalosteotomy #autograft #complications #imaging #lateralrelease #orthopedicsurgery