Preoperative Positioning and Socket-Anchor Technique for Arthroscopic Medial Patellofemoral Ligament Reconstruction Using Allograft Tendon.

Abstract

Accurate positioning of the femoral insertion of the medial patellofemoral ligament (MPFL) is the main difficulty in MPFL reconstruction. This article describes an all-arthroscopic MPFL reconstruction procedure. Preoperative 3-dimensional computed tomography assists in MPFL patellar and femoral insertion positioning, with arthroscopic reconfirmation of femoral insertion positioning through a subcutaneous tunnel during surgery. In the socket-anchor technique for patellar insertion fixation, a 10-mm-deep bone tunnel (socket) is created along a previously located guide pin at the MPFL patellar insertion; then, an absorbable suture anchor is inserted into the end of the socket to fix the tendon graft. This technique provides the advantages of being minimally invasive, yielding accurate positioning, ensuring a sufficient tendon-bone interface healing area of the graft, and having no need for intraoperative fluoroscopy.