Jefferson Brand, M. D. , Richard Hardy, Ed. D. , A. T. C

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Presentation transcript:

Medial Patella Femoral Ligament Reconstruction With Periosteal Tunnels and Suture Fixation Jefferson Brand, M.D., Richard Hardy, Ed.D., A.T.C., Paul Westerberg, M.A., A.T.C., O.T.C. Arthroscopy Techniques Volume 6, Issue 5, Pages e1973-e1978 (October 2017) DOI: 10.1016/j.eats.2017.07.019 Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 1 Guide pin is marked with a clamp. Arthroscopy Techniques 2017 6, e1973-e1978DOI: (10.1016/j.eats.2017.07.019) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 2 Patella periosteal tunnels are created. Arthroscopy Techniques 2017 6, e1973-e1978DOI: (10.1016/j.eats.2017.07.019) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 3 The tunnels are undermined with a No. 15 blade. Arthroscopy Techniques 2017 6, e1973-e1978DOI: (10.1016/j.eats.2017.07.019) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 4 First completed tunnel at the junction of the proximal 1/3 and middle 1/3 of the patella. Arthroscopy Techniques 2017 6, e1973-e1978DOI: (10.1016/j.eats.2017.07.019) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 5 Suture passed “Under, Over, Under” to allow graft passage later in the procedure. Arthroscopy Techniques 2017 6, e1973-e1978DOI: (10.1016/j.eats.2017.07.019) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 6 The second periosteal tunnel is created at the junction of the patella and quadriceps tendon. Arthroscopy Techniques 2017 6, e1973-e1978DOI: (10.1016/j.eats.2017.07.019) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 7 Suture passed “Under, Over, Under” in the second tunnel as well. Arthroscopy Techniques 2017 6, e1973-e1978DOI: (10.1016/j.eats.2017.07.019) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 8 The sutures are passed between layer 2 and layer 1. Arthroscopy Techniques 2017 6, e1973-e1978DOI: (10.1016/j.eats.2017.07.019) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 9 The graft is placed in the femoral tunnel, and secured with an interference biocomposite screw. Arthroscopy Techniques 2017 6, e1973-e1978DOI: (10.1016/j.eats.2017.07.019) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 10 The 2 limbs of the graft are separated before being passed under layer 2. Arthroscopy Techniques 2017 6, e1973-e1978DOI: (10.1016/j.eats.2017.07.019) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 11 Each graft limb is secured on each of the 2 periosteal tunnels with 2 No. 2 sutures in a figure-of-8 fashion. Arthroscopy Techniques 2017 6, e1973-e1978DOI: (10.1016/j.eats.2017.07.019) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 12 A total of 4 sutures on each graft limb are used. Arthroscopy Techniques 2017 6, e1973-e1978DOI: (10.1016/j.eats.2017.07.019) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions