Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 18, Issue 2, pp 147–151 | Cite as

Anatomical double-bundle MPFL reconstruction with an aperture fixation

  • Philip B. SchöttleEmail author
  • Daniel Hensler
  • Andreas B. Imhoff


Since biomechanical studies have shown that the medial patellofemoral ligament (MPFL) is the main restraint against lateral patella displacement, reconstruction of the MPFL has become an accepted method of restoring patellofemoral stability and numerous techniques were described. Due to biomechanical examinations and clinical results, an anatomical double-bundle reconstruction of the “sail-like” MPFL is a reasonable method for achieving stability during complete extension and lower flexion degree. This method also serves to avoid rotation of the patella, providing immediate stability throughout the normal range of motion. However, until today, an aperture fixation technique at the patellar insertion with two bundles has not been described previously. This technique can provide an immediate stability to allow an early rehabilitation with full range of motion.


MPFL Patella Instability Double bundle Aperture fixation 


  1. 1.
    Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP (2003) Anatomy and biomechanics of the medial patellofemoral ligament. Knee 10:215–220CrossRefPubMedGoogle Scholar
  2. 2.
    Brand J Jr, Weiler A, Caborn DN, Brown CH Jr, Johnson DL (2000) Graft fixation in cruciate ligament reconstruction. Am J Sports Med 28:761–774PubMedGoogle Scholar
  3. 3.
    Christiansen SE, Jacobsen BW, Lund B, Lind M (2008) Reconstruction of the medial patellofemoral ligament with gracilis tendon autograft in transverse patellar drill holes. Arthroscopy 24:82–87PubMedGoogle Scholar
  4. 4.
    Desio SM, Burks RT, Bachus KN (1998) Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med 26:59–65PubMedGoogle Scholar
  5. 5.
    Elias JJ, Cech JA, Weinstein DM, Cosgrea AJ (2004) Reducing the lateral force acting on the patella does not consistently decrease patellofemoral pressures. Am J Sports Med 32:1202–1208CrossRefPubMedGoogle Scholar
  6. 6.
    Elias JJ, Wilson DR, Adamson R, Cosgarea AJ (2004) Evaluation of a computational model used to predict the patellofemoral contact pressure distribution. J Biomech 37:295–302CrossRefPubMedGoogle Scholar
  7. 7.
    Ellera Gomes JL, Stigler Marczyk LR, Cesar de Cesar P, Jungblut CF (2004) Medial patellofemoral ligament reconstruction with semitendinosus autograft for chronic patellar instability: a follow-up study. Arthroscopy 20:147–151PubMedCrossRefGoogle Scholar
  8. 8.
    Nomura E, Inoue M (2003) Surgical technique and rationale for medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Arthroscopy 19:E47PubMedGoogle Scholar
  9. 9.
    Nomura E, Inoue M, Osada N (2005) Anatomical analysis of the medial patellofemoral ligament of the knee, especially the femoral attachment. Knee Surg Sports Traumatol Arthrosc 13:510–515CrossRefPubMedGoogle Scholar
  10. 10.
    Ostermeier S, Stukenborg-Colsman C, Wirth CJ, Bohnsack M (2007) Reconstruction of the medial patellofemoral ligament by tunnel transfer of the semitendinosus tendon. Oper Orthop Traumatol 19:489–501CrossRefPubMedGoogle Scholar
  11. 11.
    Schottle PB, Romero J, Schmeling A, Weiler A (2008) Technical note: anatomical reconstruction of the medial patellofemoral ligament using a free gracilis autograft. Arch Orthop Trauma Surg 128:479–484CrossRefPubMedGoogle Scholar
  12. 12.
    Schottle PB, Schmeling A, Rosenstiel N, Weiler A (2007) Radiographic landmarks for femoral tunnel placement in medial patellofemoral ligament reconstruction. Am J Sports Med 35:801–804CrossRefPubMedGoogle Scholar
  13. 13.
    Steensen RN, Dopirak RM, Maurus PB (2005) A simple technique for reconstruction of the medial patellofemoral ligament using a quadriceps tendon graft. Arthroscopy 21:365–370PubMedCrossRefGoogle Scholar
  14. 14.
    Steensen RN, Dopirak RM, McDonald WG 3rd (2004) The anatomy and isometry of the medial patellofemoral ligament: implications for reconstruction. Am J Sports Med 32:1509–1513CrossRefPubMedGoogle Scholar
  15. 15.
    Thaunat M, Erasmus PJ (2007) The favourable anisometry: an original concept for medial patellofemoral ligament reconstruction. Knee 14:424–428CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Philip B. Schöttle
    • 1
    Email author
  • Daniel Hensler
    • 1
  • Andreas B. Imhoff
    • 1
  1. 1.Department of Sports Orthopedics, Klinikum rechts der IsarTechnical University of MunichMünchenGermany

Personalised recommendations