In vivo positioning analysis of medial patellofemoral ligament reconstruction.

Abstract

Several techniques have been described for reconstruction of the medial patellofemoral ligament (MPFL). The anatomical insertion of the MPFL has been defined; however, there are no reports describing the accuracy of femoral graft positioning assessed postoperatively. To analyze our femoral tunnel positioning for MPFL reconstruction in correlation with our clinical results. Case series; Level of evidence, 4. The authors reported a prospective series of 29 MPFL reconstructions with a minimum follow-up of 24 months. The tunnel positioning analysis was performed using plain radiographs and magnetic resonance imaging at 1-year follow-up. Twenty-nine femoral tunnels were analyzed; 20 femoral tunnels (69%) were considered to be in good position on plain radiographs. On magnetic resonance imaging, the authors found 19 femoral tunnels (65%) in a proper location, 5 (17.5%) in a high position, and 5 in an anterior and/or high position. The study highlights the difficulty of reproducible MPFL reconstruction. The surgical procedure continues to be improved and finding a reliable technique to anatomically place the graft remains challenging. Verifying femoral tunnel placement radiographically may be recommended during surgery.