1. Preliminary clinical results after Medial Patellofemoral Ligament Reconstruction
Author: Ruzsa Paul - Gabriel
Co-author: Gal Mihaela - Alexandra
Jerdea Bogdan - Daniel
Pop Sorin - Ioan
Scientific coordinator: Lecturer Russu Octav, MD, PhD

2. The patellofemoral articulation
Role in locomotion and
activities that involve
knee flexion and extention
Patellofemoral instability
Abnormal patella movement
Dislocation or Subluxation

3. The patellofemoral articulation
94 % of patients suffer tear to the medial patellofemoral ligament following
patellar dislocation

4. Medial Patellofemoral Ligament (MPFL)
Is a band of tissue that extends from the upper aspect of the patella to the femoral medial epicondyle

5. Medial Patellofemoral Ligament (MPFL)
The most important soft tissue stabilizer of the patella (first 30⁰ of flexion)
Helps in preventing lateral patellar subluxation or dislocation

6. MPFL reconstruction
Is a surgical procedure indicated to patients with severe lateral patellar instability
Was first described in 1992 by Dr. Ellera Gomes
There have been various approaches to this technique

7. MPFL reconstruction: Double bundle technique
Replicates the native
shape of the MPFL using
a gracilis autograft which
is harvested and prepared
at the beginning of the surgery

8. 1.Preparation of the patella
2.4 mm drill tip Guide Pin
4.5 mm cannulated rimmer

9. 2.Graft fixation to the patella
bioabsorbable screw

10. 3.Preparation of the femoral insertion
MPFL Template

11. 4.Preparation of the Medial Patellofemoral Layer

12. 5. Femoral Graft Passage and Fixation

13. Postoperative considerations
Active quadriceps exercises between 0⁰ – 90⁰ of flexion
The patient can resume full activity
1 Day
6 weeks
12 weeks
Post operative knee brace locked at 0⁰ - 90⁰ of flexion and crutch until wound healing
Full range of motion with light jogging or cycling

14. Objective
To evaluate the short-term clinical results of patients after MPFL reconstruction

15. Material and methods
There have been 10 cases of MPFL reconstruction (May 2012 – April 2014) at the Orthopaedic and Traumatology II Clinic in Târgu Mureş
There were 6 female and 4 male patients between years old, all of them were diagnosed with recurrent lateral patellar dislocation
Sportivi sau nu?

16. This score is meant to asses the activity and functionality of the knee joint
Grading
< Poor
Fair
Good
> Excellent

17. Results
There were no postoperative patellar complication or redislocations and the patients regained full mobility after 6 weeks
The mean value of Tegner – Lysholm score improved to 90.8 (range ) from a preoperative mean value of 63.5 (range )

18. Conclusion
Regarding the different methods of treating lateral patellofemoral instability MPFL reconstruction is one of the most promising procedures performed nowadays thanks to its simplicity, lack of complication and patient evolution

19. Conclusion
Our results show improved knee function and physical activity in patients treated with this procedure
In order to clearly state the long-term benefits of this reconstruction technique a large scale case study is required

20. Do you have any questions?
Preliminary clinical results after Medial Patellofemoral Ligament Reconstruction

21. Thank you!

22. Bibliography
1.Shital N. Parikh, Senthil T. Nathan,Eric J. Wall and Emily A. Eismann:
Complications of Medial Patellofemoral Ligament Reconstruction in Young Patients
Am J Sports Med May 2013 41  ; 
published online before print March 28, 2013, doi: /
2. Tegner Y, Lysholm J. :
Rating systems in the evaluation of knee ligament injuries.
Clin Orthop Relat Res Sep;(198):43-9
3. Schottle PB, Hensler D, Imhoff AB:
Anatomical Double-Bundle MPFL Reconstruction with an Aperture Fixation
Knee Surg Sports Traumatol Arthroscopy (epub ahead of print), 2009.
 4.Schottle PB, Schmeling A, Rosenstiel N, Weiler A :
Radiographic Landmarks For Femoral Tunnel Placement In Medial Patellofemoral Ligament Reconstruction
Am J Sports Med 35: , 2007.
 5.Steensen RN, Dopirak RM, McDonald WG, III :
The Anatomy and Isometry of the Medial Patellofemoral Ligament: Implications for Reconstruction
Am J Sports Med 32: , 2004.