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📌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
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