Double Adjustable-Loop Cortical Buttons for Minimally Invasive Anatomic Double-Bundle Medial Patellofemoral Ligament Reconstruction.

Abstract

Recurrent patellar dislocation is a common condition in young and active individuals, with medial patellofemoral ligament (MPFL) injury being the primary pathological factor in most cases. Anatomic double-bundle MPFL reconstruction has been established as an effective treatment for patellar instability; however, the optimal fixation method remains a matter of debate. Conventional techniques often employ suture anchors and interference screws for patellar and femoral fixation, which may require larger medial incisions, compromise the extensor mechanism, and increase the risk of bone tunnel fracture or graft laceration because of screw divergence. To overcome these limitations, we describe an MPFL reconstruction technique using dual adjustable-loop cortical button fixation on both the femoral and patellar sides. This approach provides suspensory fixation with a minimal implant, preserves bone stock and soft-tissue integrity, and enables controlled graft tensioning under arthroscopic visualization. This technique represents an alternative to traditional anchor- or screw-based MPFL reconstruction methods.