Dataset Information

Medial Quadriceps Tendon Femoral Ligament Reconstruction for Anatomic Reconstruction of the Medial Patellofemoral Complex.

ABSTRACT: The medial patellofemoral complex (MPFC) refers to the primary static restraint to lateral patellar translation. Originally thought of as the medial patellofemoral ligament, anatomic studies over the past 10 years have identified the additional fibers that attach to the quadriceps tendon, which some have termed the medial quadriceps tendon femoral ligament. Anatomic studies have demonstrated that the MPFC midpoint is at the junction of the medial border of the quadriceps tendon and the articular surface of the patella, indicating that fixation can be on either structure. This technique describes a single-bundle reconstruction technique with anatomic fixation on the quadriceps tendon at the MPFC midpoint that involves fixation on the extensor mechanism first.

SUBMITTER: Tanaka MJ

PROVIDER: S-EPMC11369940 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Medial Quadriceps Tendon Femoral Ligament Reconstruction for Anatomic Reconstruction of the Medial Patellofemoral Complex.

Tanaka Miho J MJ

Arthroscopy techniques 20240504 8

The medial patellofemoral complex (MPFC) refers to the primary static restraint to lateral patellar translation. Originally thought of as the medial patellofemoral ligament, anatomic studies over the past 10 years have identified the additional fibers that attach to the quadriceps tendon, which some have termed the medial quadriceps tendon femoral ligament. Anatomic studies have demonstrated that the MPFC midpoint is at the junction of the medial border of the quadriceps tendon and the articular ...[more]

PMID: 39233802

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Project description:Recent studies on the detailed anatomy of the medial patellar stabilizer have revealed that the medial patellofemoral ligament (MPFL) not only attaches to the patella but also has fibers that attach to the quadriceps muscle, known as the medial quadriceps tendon femoral ligament (MQTFL). Reconstruction of the medial stabilizer for patellar dislocation that includes both the MPFL and MQTFL may achieve better anatomical and physiological correction. In this Technical Note, we will describe a simultaneous reconstruction technique of the MPFL and MQTFL for patellar dislocation using an artificial ligament. Technique Video Video 1 A simultaneous MPFL and MQTFL reconstruction using an artificial ligament for lateral patella instability of the left knee. The first step is to create an L-shaped patellar bone tunnel to pass through the MPFL graft. The medial aspect of the patella is exposed, and the L-shaped bone tunnel at the proximal third of the patella is created with a cannulated drill. Then, an artificial ligament (Leeds-Keio 20) is passed. The second step is to pass the MQTFL graft through the split rectus femoris. After the split is made with a sharp pointed scalpel in the middle of the rectus femoris, a curved mosquito forceps is inserted and passed between the rectus femoris and the vastus intermedius tendon, and the tip of the mosquito forceps is brought out to the medial edge of the rectus femoris tendon. An artificial ligament (Leeds-Keio 15) is clamped and folded back through the split tendon to form a loop. The final step is to create the femoral tunnel and fix the MPFL and MQTFL graft. A skin incision is made, and a guide pin is inserted at the femoral attachment of the MPFL under fluoroscopy. The artificial ligament is passed between the deep facia and the capsule of the knee joint to exit through the second incision. Then, the artificial ligament is folded over the guide pin and temporarily fixed with a pair of Kocher forceps. The stability of the patella and the tension of the artificial ligament are checked. The tension of the artificial ligament should not be excessive in knee flexion. After determining the suitable length, the position where the artificial ligament enters the femoral tunnel is marked. The section entering the bone tunnel from the marked area is cylindrically bound together with absorbable sutures, the ligament extending beyond the mark is cut off, and the tip of the remaining section is attached to a guide suture. After creating a femoral tunnel with a cannulated drill, an artificial ligament is placed using a guide suture into the bone tunnel until reaching the marked area. The artificial ligament is checked again for tension, and the artificial ligament is fixed with an interference screw. A final check is performed to ensure the stability of the patella, and the wound is closed. (MPFL, medial patellofemoral ligament; MQTFL, medial quadriceps tendon femoral ligament.)

Dataset Information

Medial Quadriceps Tendon Femoral Ligament Reconstruction for Anatomic Reconstruction of the Medial Patellofemoral Complex.

Publications

Medial Quadriceps Tendon Femoral Ligament Reconstruction for Anatomic Reconstruction of the Medial Patellofemoral Complex.

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