[Synthetic medial patellofemoral ligament reconstruction in the surgical management of patellar instability].

OBJECTIVE

Restoration of passive medial stability of the patella by reconstruction/augmentation of the medial patellofemoral ligament complex.

INDICATIONS: Treatment of first-time patellar dislocation requiring surgery and recurrent dislocation as an isolated procedure or in combination with concomitant osseous intervention.

CONTRAINDICATIONS: Patellofemoral pain without objective instability/dislocation of the patella; known material intolerance.

SURGICAL TECHNIQUE: A synthetic ligament is inserted in a V-shaped fashion into the second layer of the medial retinaculum via a 2-incision technique after soft tissue fixation in the area of the patellar medial patellofemoral complex (MPFC) and fixed at the femoral insertion using an interference screw.

POSTOPERATIVE MANAGEMENT: Partial weight-bearing for 2-3 weeks as tolerated; active and passive exercises without restriction of range of motion; immediate exercises for quadriceps muscle control, and coordinative exercises as well as stabilization of the functional pelvis-leg axis after full weight-bearing is achieved.

RESULTS

The clinical results in the literature consistently show significant improvements in the patient-reported outcome measures and are so far-along with the biomechanical data-comparable with those of autologous tendon reconstruction.