Skip to main content

Advertisement

SpringerLink
Log in

Surgical Technique for Lateral Patellofemoral Ligament Reconstruction Using Bone Tunnels: A New Method

  • Surgical Technique
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Medial patellar instability (lateral patellofemoral ligament tear) is a rare condition which is commonly associated with lateral release for lateral patellar instability. LPFL is a lateral stabilizer of the patellofemoral joint. Reconstruction of LPFL is necessary to provide stability to the patella-femoral joint in patients with instability. We describe a novel technique of trans-osseous reconstruction of LPFL to gain stability and have better graft incorporation. A doubled peroneus longus graft is inserted into the patellar tunnel and secured with an endo button on the anteromedial aspect of the patella; the other end is then inserted into the insertional point on the femur and secured with an interference screw. This is an easy, novel, and reproducible technique which can be used to reconstruct LPFL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13

Similar content being viewed by others

References

  1. Hughston, J. C., & Deese, M. (1988). Medial patella subluxation as a complication of lateral retinacular release. American Journal of Sports Medicine, 16(4), 383–388.

    Article  CAS  PubMed  Google Scholar 

  2. Shah, K. N., DeFroda, S. F., Ware, J. K., Koruprolu, S. C., & Owens, B. D. (2017). Lateral patellofemoral ligament: An anatomic study. Orthopaedic Journal of Sports Medicine., 5(12), 2325967117741439.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Rhatomy, S., Asikin, A. I. Z., Wardani, A. E., Rukmoyo, T., Lumban-Gaol, I., & Budhiparama, N. C. (2019). Peroneus longus autograft can be recommended as a superior graft to the hamstring tendon in single-bundle ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy, 27(11), 3552–3559. https://doi.org/10.1007/s00167-019-05455-w. Epub 2019 Mar 15 PMID: 30877316.

    Article  PubMed  Google Scholar 

  4. Rhatomy, S., Hartoko, L., Setyawan, R., Soekarno, N. R., Zainal-Asikin, A. I., Pridianto, D., & Mustamsir, E. (2020). Single bundle ACL reconstruction with peroneus longus tendon graft: 2-years follow-up. Journal of Clinical Orthopaedics and Trauma., 11(Suppl 3), S332–S336. https://doi.org/10.1016/j.jcot.2019.09.004. Epub 2019 Sep 6. PMID: 32523289; PMCID: PMC7275277.

    Article  PubMed  Google Scholar 

  5. Agarwal, A., Singh, S., Singh, A., & Tewari, P. (2023). Comparison of functional outcomes of an anterior cruciate ligament (ACL) reconstruction using a peroneus longus graft as an alternative to the hamstring tendon graft. Cureus., 15(4), e37273. https://doi.org/10.7759/cureus.37273. PMID: 37168157.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Keyhani, S., Qoreishi, M., Mousavi, M., Ronaghi, H., & Soleymanha, M. (2022). Peroneus longus tendon autograft versus hamstring tendon autograft in anterior cruciate ligament reconstruction: a comparative study with a mean follow-up of two years. The Archives of Bone and Joint Surgery., 10(8), 695–701. https://doi.org/10.22038/ABJS.2022.59568.2938. PMID:36258748.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Maniar, N., Cole, M. H., Bryant, A. L., & Opar, D. A. (2022). Muscle force contributions to anterior cruciate ligament loading. Sports Medicine (Auckland, N. Z.), 52(8), 1737–1750. https://doi.org/10.1007/s40279-022-01674-3. Epub 2022 Apr 18 PMID: 35437711.

    Article  PubMed  Google Scholar 

  8. Huddleston, H. P., Chahla, J., Gursoy, S., et al. (2022). A comprehensive description of the lateral patellofemoral complex: anatomy and anisometry. The American Journal of Sports Medicine., 50(4), 984–993. https://doi.org/10.1177/03635465221078033

    Article  PubMed  Google Scholar 

  9. Saper, M. (2018). Lateral patellofemoral ligament reconstruction with a gracilis allograft. Arthroscopy Techniques, 7(4), e405–e410. https://doi.org/10.1016/j.eats.2017.10.014. PMID: 29868412.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Kerzner, B., Hevesi, M., Fortier, L. M., Haynes, M. S., Gursoy, S., Dasari, S. P., Khan, Z. A., Yanke, A. B., & Chahla, J. (2022). Lateral patellofemoral ligament reconstruction with semitendinosus allograft in the setting of previous lateral release. Arthroscopy Techniques, 11(6), e1097–e1103. https://doi.org/10.1016/j.eats.2022.02.016. PMID: 35782849.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Saper, M. G., & Shneider, D. A. (2014). Lateral patellofemoral ligament reconstruction using a quadriceps tendon graft. Arthroscopy Techniques, 3(4), e445–e448. https://doi.org/10.1016/j.eats.2014.04.007. PMID: 25264506.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Chahla, J., Kunze, K. N., Fulkerson, J. P., & Yanke, A. (2019). Lateral patellofemoral ligament reconstruction: anatomy, biomechanics, indications and surgical techniques. Operative Techniques in Sports Medicine., 27(4), 150689.

    Article  Google Scholar 

  13. Hughston, J. C., Flandry, F., Brinker, M. R., Terry, G. C., & Mills, J. C., 3rd. (1996). Surgical correction of medial subluxation of the patella. The American Journal of Sports Medicine., 24(4), 486–491. https://doi.org/10.1177/036354659602400413. PMID: 8827308.

    Article  CAS  PubMed  Google Scholar 

  14. Borbas, P., Koch, P. P., & Fucentese, S. F. (2014). Lateral patellofemoral ligament reconstruction using a free gracilis autograft. Orthopedics, 37(7), e665–e668. https://doi.org/10.3928/01477447-20140626-66. PMID: 24992066.

    Article  PubMed  Google Scholar 

  15. Teitge, R. A., & Torga, S. R. (2004). Lateral patellofemoral ligament reconstruction. Arthroscopy, 20(9), 998–1002. https://doi.org/10.1016/j.arthro.2004.07.005. PMID: 15525935.

    Article  PubMed  Google Scholar 

  16. Beckert, M., Crebs, D., Nieto, M., Gao, Y., & Albright, J. (2016). Lateral patellofemoral ligament reconstruction to restore functional capacity in patients previously undergoing lateral retinacular release. World Journal of Clinical Cases., 4(8), 202–206. https://doi.org/10.12998/wjcc.v4.i8.202. PMID: 27574606.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Fortis Hospital, Sector 62, Mohali, Punjab, 160062, India

    M. Arora & T. Shukla

  2. Department of Orthopaedics, Dr. Chandramma Dayanand Sagar Institute of Medical Education and Research (CDSIMER), Deverakaggalahalli, Kanakapura, Karnataka, 562112, India

    P. M. Rathod

Authors
  1. M. Arora
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Shukla
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. M. Rathod
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. M. Rathod.

Ethics declarations

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standard statement

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

Informed consent

For this type of study, informed consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Arora, M., Shukla, T. & Rathod, P.M. Surgical Technique for Lateral Patellofemoral Ligament Reconstruction Using Bone Tunnels: A New Method. JOIO 58, 330–337 (2024). https://doi.org/10.1007/s43465-023-01091-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43465-023-01091-2

Keywords

Search

Navigation