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Fascia Lata Allograft Medial Patellofemoral Ligament Reconstruction-Restore the Nature As Close As Possible

Overview
Journal Arthrosc Tech
Publisher Elsevier
Date 2025 Mar 5
PMID 40041350
Authors
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Abstract

Various surgical techniques for medial patellofemoral ligament (MPFL) reconstruction have been described, commonly using hamstring auto- or allografts. Despite their widespread use, these techniques have limitations due to the tubular structure of the hamstring tendons, which does not match the flat, sail-like anatomy of the MPFL. Furthermore, over- or undertensioning of the graft due to tunnel misplacement remains a significant risk, even if anatomic and radiologic landmarks are used. To address these issues, a fascia lata allograft MPFL reconstruction with assessment of angular anisometry is presented. This technique allows for reconstruction of the MPFL as close as possible to its nature with a flat and wide patellar attachment and a gradual transition of maximal tension across the graft fibers, depending on the knee flexion angle. Precise intraoperative control of predefined graft angular anisometry allows for achievement of the desired amount of tension at specific flexion angles. This mitigates the risk of under- or overtensioning and subsequently ensures proper medial-lateral mobility of the patella.

References
1.
De Maeseneer M, VAN Roy F, Lenchik L, Barbaix E, De Ridder F, Osteaux M . Three layers of the medial capsular and supporting structures of the knee: MR imaging-anatomic correlation. Radiographics. 2000; 20 Spec No:S83-9. DOI: 10.1148/radiographics.20.suppl_1.g00oc05s83. View

2.
Migliorini F, Marsilio E, Cuozzo F, Oliva F, Eschweiler J, Hildebrand F . Chondral and Soft Tissue Injuries Associated to Acute Patellar Dislocation: A Systematic Review. Life (Basel). 2021; 11(12). PMC: 8706453. DOI: 10.3390/life11121360. View

3.
Mostowy M, Puzio T, Matera K, Koziel M, Stanek J, Bawor M . Quadriceps muscle contraction causes medial patellofemoral ligament elongation by intermeshed fibers of vastus medialis oblique muscle. J Anat. 2023; 244(2):325-332. PMC: 10780142. DOI: 10.1111/joa.13954. View

4.
Balcarek P, Walde T . Accuracy of femoral tunnel placement in medial patellofemoral ligament reconstruction: the effect of a nearly true-lateral fluoroscopic view. Am J Sports Med. 2015; 43(9):2228-32. DOI: 10.1177/0363546515591265. View

5.
Dandu N, Trasolini N, Hevesi M, Zavras A, Elias T, Haneberg E . Landmarks Used in Medial Patellofemoral Ligament Reconstruction Have Variable Topography. Arthrosc Sports Med Rehabil. 2022; 4(6):e2043-e2050. PMC: 9791883. DOI: 10.1016/j.asmr.2022.09.003. View