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Avoiding Complications with MPFL Reconstruction

  • Advances in Patellofemoral Surgery (L Redler, section editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

To discuss the potentially significant complications associated with medial patellofemoral ligament (MPFL) reconstruction. Additionally, to review the most current and relevant literature with an emphasis on avoiding these potential complications.

Recent Findings

Multiple cadaveric studies have characterized the anatomy of the MPFL and the related morphologic abnormalities that contribute to recurrent lateral patellar instability. Such abnormalities include patella alta, excessive tibial tubercle to trochlear grove (TT-TG) distance, trochlear dysplasia, and malalignment. Recent studies have evaluated the clinical outcomes associated with the treatment of concomitant pathology in combination with MPFL reconstruction, which is critical in avoiding recurrent instability and complications.

Summary

Although there remains a lack of consensus regarding various critical aspects of MPFL reconstruction, certain concepts remain imperative. Our preferred methods and rationales for surgical techniques are described. These include appropriate work up, a combination of procedures to address abnormal morphology, anatomical femoral insertion, safe and secure patellar fixation, appropriate graft length fixation, and thoughtful knee flexion during fixation.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Sports Medicine Division, University of Virginia, 400 Ray C. Hunt Drive, Third Floor, Charlottesville, FL, 22903, USA

    Marvin K. Smith, Brian C. Werner & David R. Diduch

Authors
  1. Marvin K. Smith
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  2. Brian C. Werner
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  3. David R. Diduch
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Correspondence to David R. Diduch.

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Conflict of Interest

David R. Diduch reports personal fees from Depuy Mitek and grants from Zimmer outside of the submitted work. Brian C. Werner reports research support from Arthrex, Inc. and Biomet, Inc., outside of the submitted work, and is a committee member for AOSSM. Marvin K. Smith has no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Advances in Patellofemoral Surgery

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Smith, M.K., Werner, B.C. & Diduch, D.R. Avoiding Complications with MPFL Reconstruction. Curr Rev Musculoskelet Med 11, 241–252 (2018). https://doi.org/10.1007/s12178-018-9479-y

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  • DOI: https://doi.org/10.1007/s12178-018-9479-y

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